Clinical Payment and Coding Policies

Avalon - Lab Benefit Management Program

Effective Nov. 1, 2022, BCBSOK will implement its new program with Avalon Healthcare Solutions for claims for certain outpatient laboratory services provided to many of our commercial and BlueCard® (out of area) members. Learn more.

View the current policies below:


Policy Name Policy Number Posted Archived Documents
Flow Cytometry  CPCPLAB001 8/22/2022  
Cervical Cancer Screening  CPCPLAB002 8/22/2022  
Vitamin D  CPCPLAB003 8/22/2022  
Hemoglobin A1c  CPCPLAB004 8/22/2022  
Prostate Biopsies  CPCPLAB005 8/22/2022  
Prostate Specific Antigen Testing  CPCPLAB006 8/22/2022  
Preventive Screening in Adults  CPCPLAB007 8/22/2022  
Diagnostic Testing of Iron Homeostasis & Metabolism  CPCPLAB008 8/22/2022  
Testosterone Testing  CPCPLAB009 8/22/2022  
Vitamin B12 and Methylmalonic Acid Testing  CPCPLAB010 8/22/2022  
ANA/ENA Testing  CPCPLAB011 8/22/2022  
Pre-Operative Testing  CPCPLAB012 8/22/2022  
Allergen Testing  CPCPLAB013 8/22/2022  
Prenatal Screening  CPCPLAB014 8/22/2022  
Hepatitis C  CPCPLAB015 8/22/2022  
Pediatric Preventive Screening  CPCPLAB016 8/22/2022  
Celiac Disease Testing  CPCPLAB017 8/22/2022  
Helicobacter Pylori Testing  CPCPLAB018 8/22/2022  
Thyroid Disease Testing  CPCPLAB019 8/22/2022  
Cardiovascular Disease Risk Assessment  CPCPLAB020 8/22/2022  
Prenatal Screening for Fetal Aneuploidy  CPCPLAB022 8/22/2022  
Diagnosis of Idiopathic Environmental Intolerance  CPCPLAB023 8/22/2022  
Epithelial Cell Cytology in Breast Cancer Risk Assessment  CPCPLAB024 8/22/2022  
Fecal Analysis in the Diagnosis of Intestinal Dysbiosis  CPCPLAB025 8/22/2022  
Fecal Calprotectin Testing  CPCPLAB026 8/22/2022  
Testing for Diagnosis of Active or Latent Tuberculosis  CPCPLAB027 8/22/2022  
Immune Cell Function Assay  CPCPLAB028 8/22/2022  
Intracellular Micronutrient Analysis  CPCPLAB029 8/22/2022  
In Vitro Chemoresistance and Chemosensitivities Assays  CPCPLAB030 8/22/2022  
Measurement of Thromboxane Metabolites for ASA Resistance  CPCPLAB031 8/22/2022  
Oral Screening Lesion Identification Systems and Genetic Screening  CPCPLAB032 8/22/2022  
Diagnostic Testing of Influenza  CPCPLAB033 8/22/2022  
Salivary Hormone Testing  CPCPLAB034 8/22/2022  
Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease  CPCPLAB035 8/22/2022  
Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases  CPCPLAB036 8/22/2022  
Serum Tumor Markers for Malignancies  CPCPLAB037 8/22/2022  
Urinary Tumor Markers for Bladder Cancer  CPCPLAB038 8/22/2022  
Vectra DA Blood Test for Rheumatoid Arthritis  CPCPLAB039 8/22/2022  
ST2 Assay for Chronic Heart Failure  CPCPLAB040 8/22/2022  
Erectile Dysfunction  CPCPLAB041 2/15/2023 CPCLAB041v1
ZIKA Virus Risk Assessment  CPCPLAB042 8/22/2022  
Evaluation of Dry Eyes  CPCPLAB043 8/22/2022  
Lyme Disease  CPCPLAB044 8/22/2022  
Pathogen Panel Testing  CPCPLAB045 8/22/2022  
Cardiac Biomarkers for Myocardial Infarction  CPCPLAB046 8/22/2022  
Pancreatic Enzyme Testing for Acute Pancreatitis  CPCPLAB047 8/22/2022  
Folate Testing  CPCPLAB048 8/22/2022  
General Inflammation Testing  CPCPLAB049 8/22/2022  
Urine Culture Testing for Bacteria  CPCPLAB050 8/22/2022  
Diagnostic Testing of Common Sexually Transmitted Infections  CPCPLAB051 8/22/2022  
Testing for Mosquito- or Tick-Related Infections  CPCPLAB052 8/22/2022  
β-Hemolytic Streptococcus Testing  CPCPLAB053 8/22/2022  
Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing  CPCPLAB055 8/22/2022  
Gamma-glutamyl Transferase  CPCPLAB056 8/22/2022  
Coronavirus Testing in the Outpatient Setting  CPCPLAB057 8/22/2022  
Venous and Arterial Thrombosis Risk Testing  CPCPLAB058 8/22/2022  
Diagnosis of Vaginitis including Multi-target PCR Testing  CPCPLAB059 8/22/2022  
Genetic Testing for Adolescent Idiopathic Scoliosis  CPCPLAB060 8/22/2022  
Testing for Alpha-1 Antitrypsin Deficiency  CPCPLAB061 8/22/2022  
Identification of Microorganisms using Nucleic Acid Probes  CPCPLAB063 8/22/2022  
Nerve Fiber Density Testing  CPCPLAB064 8/22/2022  
Plasma HIV-1 and HIV-2 RNA Quantification for HIV Infection  CPCPLAB065 8/22/2022  
DNA Ploidy Cell Cycle Analysis  CPCPLAB066 8/22/2022  
Testing of Homocysteine Metabolism-Related Conditions  CPCPLAB067 8/22/2022  
Onychomycosis Testing  CPCPLAB068 8/22/2022  
Immunohistochemistry  CPCPLAB069 8/22/2022  
Prescription Medication and Illicit Drug Testing in the Outpatient Setting  CPCPLAB070 8/22/2022  

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