75573 prior authorization | Blue Cross Blue Shield Oklahoma
75573, Computed Tomography Heart With Contrast Material For Evaluation Of Cardiac Structure And Morphology In The Setting Of Congenital Heart Disease (Including 3D Image Postprocessing Assessment Of Left Ventricular [Lv] Cardiac Function Right Ventricular [Rv] Structure And Function And Evaluation Of Vascular Structures If Performed), is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.
- Code
- 75573
- Description
- Computed Tomography Heart With Contrast Material For Evaluation Of Cardiac Structure And Morphology In The Setting Of Congenital Heart Disease (Including 3D Image Postprocessing Assessment Of Left Ventricular [Lv] Cardiac Function Right Ventricular [Rv] Structure And Function And Evaluation Of Vascular Structures If Performed)
- Source
- 2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 27 Original policy