55874 prior authorization | Blue Cross Blue Shield Oklahoma

55874, Transperineal Placement Of Biodegradable Material Peri- Prostatic Single Or Multiple Injection(S) Including Image Guidance When Performed, is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.

Code: 55874
Description: Transperineal Placement Of Biodegradable Material Peri- Prostatic Single Or Multiple Injection(S) Including Image Guidance When Performed
Source: 2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 209 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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