54416 prior authorization | Blue Cross Blue Shield Oklahoma

54416, Removal and replacement of non-inflatable (semi rigid) or inflatable (self-contained) penile prosthesis at the same operative session, is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.

Code: 54416
Description: Removal and replacement of non-inflatable (semi rigid) or inflatable (self-contained) penile prosthesis at the same operative session
Source: 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 238 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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