S9366 prior authorization | Blue Cross Blue Shield Oklahoma
S9366, Home Infusion Therapy Total Parenteral Nutrition (Tpn); More Than One Liter But No More Than Two Liters Per Day Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment Including Standard Tpn Formula (Lipids Specialty Amino Acid Formulas Drugs Other Than In Standard Formula And Nursing Visits Coded Separately) Per Diem, is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.
- Code
- S9366
- Description
- Home Infusion Therapy Total Parenteral Nutrition (Tpn); More Than One Liter But No More Than Two Liters Per Day Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment Including Standard Tpn Formula (Lipids Specialty Amino Acid Formulas Drugs Other Than In Standard Formula And Nursing Visits Coded Separately) Per Diem
- Source
- 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 221 Original policy