0165T prior authorization | Blue Cross Blue Shield Oklahoma

0165T, Revision Including Replacement Of Total Disc Arthroplasty (Artificial Disc) Anterior Approach Each Additional Interspace Lumbar (List Separately In Addition To Code For Primary Procedure), is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.

Code: 0165T
Description: Revision Including Replacement Of Total Disc Arthroplasty (Artificial Disc) Anterior Approach Each Additional Interspace Lumbar (List Separately In Addition To Code For Primary Procedure)
Source: 2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 192 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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