Standards and Requirements


Clinical Payment and Coding Policies

Clinical payment and coding policies are based on criteria developed by specialized professional societies, national guidelines Millman Care Guidelines (MCG) and the CMS Provider Reimbursement Manual. Learn more.


ICD-10

ICD-10, the means by which Blue Cross and Blue Shield of Oklahoma (BCBSOK) exchanges member data with providers, will change dramatically over the next several years. Explore ICD-10 changes.


Medical Policies

Medical Policies are based on research that provides evidence of scientific merit for a particular medical technology. In most cases, they are used as guidelines for coverage determinations in health care benefit programs. Explore more about Medical Policies, as well as restriction and limitations .


Draft Medical Policies

Medical Policies are based on scientific and medical research. They are often used as guidelines for coverage determinations in health care benefit programs. Explore Medical Policy drafts that are currently being considered, with an opportunity to provide feedback .


Medical Policy Router (out-of-area members)

Medical Policy Router (out-of-area members)