75572 prior authorization | Blue Cross Blue Shield Oklahoma

75572, Computed Tomography Heart With Contrast Material For Evaluation Of Cardiac Structure And Morphology (Including 3D Image Postprocessing Assessment Of Cardiac Function And Evaluation Of Venous Structures If Performed), is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.

Code: 75572
Description: Computed Tomography Heart With Contrast Material For Evaluation Of Cardiac Structure And Morphology (Including 3D Image Postprocessing Assessment Of Cardiac Function And Evaluation Of Venous Structures If Performed)
Source: 2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 27 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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