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 NamePolicy NumberPostedEffectiveArchived Documents
Flow Cytometry CPCPLAB00111/13/202401/15/2025View Archive
Cervical Cancer Screening CPCPLAB00211/20/202401/15/2025View Archive
Vitamin D Testing CPCPLAB00302/15/202504/15/2025View Archive
Diabetes Mellitus Testing CPCPLAB00402/15/202504/15/2025View Archive
Prostate Biopsy Specimen Analysis CPCPLAB00511/13/202401/15/2025View Archive
Prostate Specific Antigen Testing CPCPLAB00611/13/202401/15/2025View Archive
Diagnostic Testing of Iron Homeostasis & Metabolism CPCPLAB00802/15/202504/15/2025View Archive
Testosterone CPCPLAB00902/15/202504/15/2025View Archive
Vitamin B12 and Methylmalonic Acid Testing CPCPLAB01002/15/202504/15/2025View Archive
Biomarker Testing for Autoimmune Rheumatic Disease CPCPLAB01111/20/202401/15/2025View Archive
Allergen Testing CPCPLAB01311/13/202401/15/2025View Archive
Prenatal Screening (Nongenetic) CPCPLAB01411/13/202401/15/2025View Archive
Hepatitis Testing CPCPLAB01511/13/202401/15/2025View Archive
Pediatric Preventive Screening CPCPLAB01611/13/202401/15/2025View Archive
Celiac Disease Testing CPCPLAB01711/13/202401/15/2025View Archive
Helicobacter Pylori Testing CPCPLAB01811/20/202401/15/2025View Archive
Thyroid Disease Testing CPCPLAB01911/13/202401/15/2025View Archive
Cardiovascular Disease Risk Assessment CPCPLAB02002/07/202504/15/2025View Archive
Diagnosis of Idiopathic Environmental Intolerance CPCPLAB02302/15/202504/15/2025View Archive
Epithelial Cell Cytology in Breast Cancer Risk Assessment CPCPLAB02411/13/202401/15/2025View Archive
Fecal Analysis in the Diagnosis of Intestinal Dysbiosis CPCPLAB02511/14/202401/15/2025View Archive
Fecal Calprotectin Testing in Adults CPCPLAB02611/14/202401/15/2025View Archive
Testing for Diagnosis of Active or Latent Tuberculosis CPCPLAB02711/20/202401/15/2025View Archive
Immune Cell Function Assay CPCPLAB02802/15/202504/15/2025View Archive
Intracellular Micronutrient Analysis CPCPLAB02911/14/202401/15/2025View Archive
In Vitro Chemoresistance and Chemosensitivities Assays CPCPLAB03011/20/202401/15/2025View Archive
Oral Cancer Screening and Testing CPCPLAB03202/15/202504/15/2025View Archive
Diagnostic Testing of Influenza CPCPLAB03311/14/202401/15/2025View Archive
Salivary Hormone Testing CPCPLAB03411/14/202401/15/2025View Archive
Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease CPCPLAB03511/15/202401/15/2025View Archive
Serum Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases CPCPLAB03611/20/202401/15/2025View Archive
Serum Tumor Markers for Malignancies CPCPLAB03711/14/202401/15/2025View Archive
Urinary Tumor Markers for Bladder Cancer CPCPLAB03802/07/202504/15/2025View Archive
Evaluation of Dry Eyes CPCPLAB04311/14/202401/15/2025View Archive
Lyme Disease CPCPLAB04411/14/202401/15/2025View Archive
Pathogen Panel Testing CPCPLAB04502/07/202504/15/2025View Archive
Biomarkers for Myocardial Infarction and Chronic Heart Failure CPCPLAB04611/14/202401/15/2025View Archive
Pancreatic Enzyme Testing for Acute Pancreatitis CPCPLAB04711/14/202401/15/2025View Archive
Folate Testing CPCPLAB04811/14/202401/15/2025View Archive
General Inflammation Testing CPCPLAB04911/14/202401/15/2025View Archive
Urine Culture Testing for Bacteria CPCPLAB05011/14/202401/15/2025View Archive
Diagnostic Testing of Common Sexually Transmitted Infections CPCPLAB05102/15/202504/15/2025View Archive
Testing for Vector-Borne Infections CPCPLAB05211/14/202401/15/2025View Archive
β-Hemolytic Streptococcus Testing CPCPLAB05311/20/202401/15/2025View Archive
Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing CPCPLAB05511/15/202401/15/2025View Archive
Gamma-glutamyl Transferase CPCPLAB05611/14/202401/15/2025View Archive
Coronavirus Testing in the Outpatient Setting CPCPLAB05702/15/202504/15/2025View Archive
Venous and Arterial Thrombosis Risk Testing CPCPLAB05811/14/202401/15/2025View Archive
Diagnosis of Vaginitis CPCPLAB05911/20/202401/15/2025View Archive
Testing for Alpha-1 Antitrypsin Deficiency CPCPLAB06111/14/202401/15/2025View Archive
Identification of Microorganisms using Nucleic Acid Probes CPCPLAB06311/14/202401/15/2025View Archive
Nerve Fiber Density Testing CPCPLAB06411/14/202401/15/2025View Archive
Human Immunodeficiency Virus (HIV) CPCPLAB06511/14/202401/15/2025View Archive
Testing of Homocysteine Metabolism-Related Conditions CPCPLAB06702/15/202504/15/2025View Archive
Onychomycosis Testing CPCPLAB06811/14/202401/15/2025View Archive
Immunohistochemistry CPCPLAB06902/15/202504/15/2025View Archive
Prescription Medication and Illicit Drug Testing in the Outpatient Setting
 CPCPLAB07011/14/202401/15/2025View Archive
Colorectal Cancer Screening CPCPLAB07111/14/202401/15/2025View Archive

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