BCBS Oklahoma · PayerPolicy · BCBSOK-SUR704.012
Summary of the payer’s published policy. Not a coverage determination — confirm with BCBS Oklahoma before submitting.
Free account. Policy pages stay open to everyone.
Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.
| Code | Code system | Status in this policy |
|---|---|---|
| 15011 | CPT | Covered |
| 15012 | CPT | Covered |
| 15013 | CPT | Covered |
| 15014 | CPT | Covered |
| 15015 | CPT | Covered |
| 15016 | CPT | Covered |
| 15017 | CPT | Covered |
| 15018 | CPT | Covered |
| 15271 | CPT | Covered |
| 15272 | CPT | Covered |
| 15273 | CPT | Covered |
| 15274 | CPT | Covered |
| 15275 | CPT | Covered |
| 15276 | CPT | Covered |
| 15277 | CPT | Covered |
| 15278 | CPT | Covered |
| 15777 | CPT | Covered |
| A2002 | HCPCS | Covered |
| A2003 | HCPCS | Covered |
| A2004 | HCPCS | Covered |
| A2005 | HCPCS | Covered |
| A2006 | HCPCS | Covered |
| A2007 | HCPCS | Covered |
| A2008 | HCPCS | Covered |
| A2009 | HCPCS | Covered |
| A2010 | HCPCS | Covered |
| A2011 | HCPCS | Covered |
| A2012 | HCPCS | Covered |
| A2013 | HCPCS | Covered |
| A2014 | HCPCS | Covered |
| A2015 | HCPCS | Covered |
| A2016 | HCPCS | Covered |
| A2017 | HCPCS | Covered |
| A2018 | HCPCS | Covered |
| A2019 | HCPCS | Covered |
| A2020 | HCPCS | Covered |
| A2021 | HCPCS | Covered |
| A2022 | HCPCS | Covered |
| A2023 | HCPCS | Covered |
| A2024 | HCPCS | Covered |
| A2025 | HCPCS | Covered |
| A2026 | HCPCS | Covered |
| A2027 | HCPCS | Covered |
| A2028 | HCPCS | Covered |
| A2029 | HCPCS | Covered |
| A2030 | HCPCS | Covered |
| A2031 | HCPCS | Covered |
| A2032 | HCPCS | Covered |
| A2033 | HCPCS | Covered |
| A2034 | HCPCS | Covered |
| A2035 | HCPCS | Covered |
| A2040 | HCPCS | Covered |
| A2041 | HCPCS | Covered |
| A2042 | HCPCS | Covered |
| A2043 | HCPCS | Covered |
| A2044 | HCPCS | Covered |
| A2045 | HCPCS | Covered |
| A4100 | HCPCS | Covered |
| A6460 | HCPCS | Covered |
| A6461 | HCPCS | Covered |
| C1832 | HCPCS | Covered |
| C5271 | HCPCS | Covered |
| C5272 | HCPCS | Covered |
| C5273 | HCPCS | Covered |
| C5274 | HCPCS | Covered |
| C5275 | HCPCS | Covered |
| C5276 | HCPCS | Covered |
| C5277 | HCPCS | Covered |
| C5278 | HCPCS | Covered |
| C8002 | HCPCS | Covered |
| C9354 | HCPCS | Covered |
| C9356 | HCPCS | Covered |
| C9358 | HCPCS | Covered |
| C9360 | HCPCS | Covered |
| C9363 | HCPCS | Covered |
| C9364 | HCPCS | Covered |
| G0681 | HCPCS | Covered |
| G0682 | HCPCS | Covered |
| G0683 | HCPCS | Covered |
| G0684 | HCPCS | Covered |
| Q4100 | HCPCS | Covered |
| Q4101 | HCPCS | Covered |
| Q4102 | HCPCS | Covered |
| Q4103 | HCPCS | Covered |
| Q4104 | HCPCS | Covered |
| Q4105 | HCPCS | Covered |
| Q4106 | HCPCS | Covered |
| Q4107 | HCPCS | Covered |
| Q4108 | HCPCS | Covered |
| Q4110 | HCPCS | Covered |
| Q4111 | HCPCS | Covered |
| Q4112 | HCPCS | Covered |
| Q4113 | HCPCS | Covered |
| Q4114 | HCPCS | Covered |
| Q4115 | HCPCS | Covered |
| Q4116 | HCPCS | Covered |
| Q4117 | HCPCS | Covered |
| Q4118 | HCPCS | Covered |
| Q4121 | HCPCS | Covered |
| Q4122 | HCPCS | Covered |
| Q4123 | HCPCS | Covered |
| Q4124 | HCPCS | Covered |
| Q4125 | HCPCS | Covered |
| Q4126 | HCPCS | Covered |
| Q4127 | HCPCS | Covered |
| Q4128 | HCPCS | Covered |
| Q4130 | HCPCS | Covered |
| Q4134 | HCPCS | Covered |
| Q4135 | HCPCS | Covered |
| Q4136 | HCPCS | Covered |
| Q4141 | HCPCS | Covered |
| Q4142 | HCPCS | Covered |
| Q4143 | HCPCS | Covered |
| Q4146 | HCPCS | Covered |
| Q4147 | HCPCS | Covered |
| Q4149 | HCPCS | Covered |
| Q4152 | HCPCS | Covered |
| Q4158 | HCPCS | Covered |
| Q4161 | HCPCS | Covered |
| Q4164 | HCPCS | Covered |
| Q4165 | HCPCS | Covered |
| Q4166 | HCPCS | Covered |
| Q4167 | HCPCS | Covered |
| Q4169 | HCPCS | Covered |
| Q4175 | HCPCS | Covered |
| Q4179 | HCPCS | Covered |
| Q4182 | HCPCS | Covered |
| Q4189 | HCPCS | Covered |
| Q4190 | HCPCS | Covered |
| Q4193 | HCPCS | Covered |
| Q4195 | HCPCS | Covered |
| Q4196 | HCPCS | Covered |
| Q4197 | HCPCS | Covered |
| Q4200 | HCPCS | Covered |
| Q4202 | HCPCS | Covered |
| Q4203 | HCPCS | Covered |
| Q4216 | HCPCS | Covered |
| Q4220 | HCPCS | Covered |
| Q4222 | HCPCS | Covered |
| Q4226 | HCPCS | Covered |
| Q4345 | HCPCS | Covered |