Please review the codes that must meet BCBSOK medical policy criteria before services can be considered for benefits. Please review our medical policy criteria before rendering services. A predetermination can be requested for the services on this list.
If a predetermination is not obtained, please submit supporting medical documentation with your claim.
There are also codes that are considered not corporately covered . A predetermination is not necessary for these services.
* This is not an all inclusive listing.