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 Effective Archived Documents
Flow Cytometry  CPCPLAB001 08/31/2023 11/01/2023 View Archive
Cervical Cancer Screening  CPCPLAB002 08/30/2023 11/01/2023 View Archive
Vitamin D  CPCPLAB003 06/08/2023 06/15/2023 View Archive
Hemoglobin A1c  CPCPLAB004 06/08/2023 08/15/2023 View Archive
Prostate Biopsies  CPCPLAB005 08/31/2023 11/01/2023 View Archive
Prostate Specific Antigen Testing  CPCPLAB006 06/08/2023 06/15/2023 View Archive
Diagnostic Testing of Iron Homeostasis & Metabolism  CPCPLAB008 06/08/2023 06/15/2023 View Archive
Testosterone Testing  CPCPLAB009 08/31/2023 11/01/2023 View Archive
Vitamin B12 and Methylmalonic Acid Testing  CPCPLAB010 08/30/2023 11/01/2023 View Archive
Biomarker Testing for Autoimmune Rheumatic Disease  CPCPLAB011 08/31/2023 11/01/2023 View Archive
Allergen Testing  CPCPLAB013 06/08/2023 06/15/2023 View Archive
Prenatal Screening  CPCPLAB014 11/01/2023 11/01/2023 View Archive
Hepatitis C  CPCPLAB015 08/31/2023 11/01/2023 View Archive
Pediatric Preventive Screening  CPCPLAB016 08/30/2023 11/01/2023 View Archive
Celiac Disease Testing  CPCPLAB017 08/30/2023 11/01/2023 View Archive
Helicobacter Pylori Testing  CPCPLAB018 06/08/2023 06/15/2023 View Archive
Thyroid Disease Testing  CPCPLAB019 06/08/2023 06/15/2023 View Archive
Cardiovascular Disease Risk Assessment  CPCPLAB020 08/30/2023 11/01/2023 View Archive
Prenatal Screening for Fetal Aneuploidy  CPCPLAB022 08/31/2023 11/01/2023  
Diagnosis of Idiopathic Environmental Intolerance  CPCPLAB023 10/31/2023 11/01/2023 View Archive
Epithelial Cell Cytology in Breast Cancer Risk Assessment  CPCPLAB024 08/30/2023 11/01/2023 View Archive
Fecal Analysis in the Diagnosis of Intestinal Dysbiosis  CPCPLAB025 08/30/2023 11/01/2023 View Archive
Fecal Calprotectin Testing  CPCPLAB026 08/31/2023 11/01/2023 View Archive
Testing for Diagnosis of Active or Latent Tuberculosis  CPCPLAB027 08/31/2023 11/01/2023 View Archive
Immune Cell Function Assay  CPCPLAB028 08/30/2023 11/01/2023 View Archive
Intracellular Micronutrient Analysis  CPCPLAB029 06/08/2023 06/15/2023 View Archive
In Vitro Chemoresistance and Chemosensitivities Assays  CPCPLAB030 08/30/2023 11/01/2023 View Archive
Oral Screening Lesion Identification Systems and Genetic Screening  CPCPLAB032 08/30/2023 11/01/2023 View Archive
Diagnostic Testing of Influenza  CPCPLAB033 08/31/2023 11/01/2023 View Archive
Salivary Hormone Testing  CPCPLAB034 06/08/2023 06/15/2023 View Archive
Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease  CPCPLAB035 08/30/2023 11/01/2023 View Archive
Serum Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases  CPCPLAB036 08/30/2023 11/01/2023 View Archive
Serum Tumor Markers for Malignancies  CPCPLAB037 08/30/2023 11/01/2023 View Archive
Urinary Tumor Markers for Bladder Cancer  CPCPLAB038 08/31/2023 11/01/2023 View Archive
ST2 Assay for Chronic Heart Failure  CPCPLAB040 08/22/2022 11/01/2022  
Evaluation of Dry Eyes  CPCPLAB043 06/08/2023 06/15/2023 View Archive
Lyme Disease  CPCPLAB044 08/31/2023 11/01/2023 View Archive
Pathogen Panel Testing  CPCPLAB045 08/30/2023 11/01/2023 View Archive
Cardiac Biomarkers for Myocardial Infarction  CPCPLAB046 08/30/2023 11/01/2023 View Archive
Pancreatic Enzyme Testing for Acute Pancreatitis  CPCPLAB047 08/30/2023 11/01/2023 View Archive
Folate Testing  CPCPLAB048 08/30/2023 11/01/2023 View Archive
General Inflammation Testing  CPCPLAB049 08/30/2023 11/01/2023 View Archive
Urine Culture Testing for Bacteria  CPCPLAB050 08/30/2023 11/01/2023 View Archive
Diagnostic Testing of Common Sexually Transmitted Infections  CPCPLAB051 10/31/2023 11/01/2023 View Archive
Testing for Mosquito- or Tick-Related Infections  CPCPLAB052 08/30/2023 11/01/2023 View Archive
β-Hemolytic Streptococcus Testing  CPCPLAB053 08/30/2023 11/01/2023 View Archive
Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing  CPCPLAB055 06/08/2023 06/15/2023 View Archive
Gamma-glutamyl Transferase  CPCPLAB056 08/30/2023 11/01/2023 View Archive
Coronavirus Testing in the Outpatient Setting  CPCPLAB057 08/30/2023 11/01/2023 View Archive
Venous and Arterial Thrombosis Risk Testing  CPCPLAB058 08/30/2023 11/01/2023 View Archive
Diagnosis of Vaginitis including Multi-target PCR Testing  CPCPLAB059 08/30/2023 11/01/2023 View Archive
Testing for Alpha-1 Antitrypsin Deficiency  CPCPLAB061 08/31/2023 11/01/2023 View Archive
Identification of Microorganisms using Nucleic Acid Probes  CPCPLAB063 08/31/2023 11/01/2023 View Archive
Nerve Fiber Density Testing  CPCPLAB064 08/31/2023 11/01/2023 View Archive
Human Immunodeficiency Virus (HIV)  CPCPLAB065 08/31/2023 11/01/2023 View Archive
Testing of Homocysteine Metabolism-Related Conditions  CPCPLAB067 08/31/2023 11/01/2023  
Onychomycosis Testing  CPCPLAB068 06/08/2023 06/15/2023 View Archive
Immunohistochemistry  CPCPLAB069 06/08/2023 06/15/2023 View Archive
Prescription Medication and Illicit Drug Testing in the Outpatient Setting
 CPCPLAB070 08/31/2023 11/01/2023 View Archive
Colorectal Cancer Screening  CPCPLAB071 08/31/2023 11/01/2023  

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