Clinical Payment and Coding Policies

Avalon - Lab Benefit Management Program

Effective Nov. 1, 2022, BCBSOK will implement its new program with Avalon Healthcare Solutions for claims for certain outpatient laboratory services provided to many of our commercial and BlueCard® (out of area) members. Learn more.

View the current policies below:

 

Policy Name Policy Number Posted Effective Archived Documents
Flow Cytometry  CPCPLAB001 11/13/2024 01/15/2025 View Archive
Cervical Cancer Screening  CPCPLAB002 11/20/2024 01/15/2025 View Archive
Vitamin D Testing  CPCPLAB003 02/05/2024 03/15/2024 View Archive
Diabetes Mellitus Testing  CPCPLAB004 01/31/2024 04/15/2024 View Archive
Prostate Biopsy Specimen Analysis  CPCPLAB005 11/13/2024 01/15/2025 View Archive
Prostate Specific Antigen Testing  CPCPLAB006 11/13/2024 01/15/2025 View Archive
Diagnostic Testing of Iron Homeostasis & Metabolism  CPCPLAB008 02/01/2024 03/15/2024 View Archive
Testosterone  CPCPLAB009 02/05/2024 03/15/2024 View Archive
Vitamin B12 and Methylmalonic Acid Testing  CPCPLAB010 11/13/2024 01/15/2025 View Archive
Biomarker Testing for Autoimmune Rheumatic Disease  CPCPLAB011 11/20/2024 01/15/2025 View Archive
Allergen Testing  CPCPLAB013 11/13/2024 01/15/2025 View Archive
Prenatal Screening (Nongenetic)  CPCPLAB014 11/13/2024 01/15/2025 View Archive
Hepatitis Testing  CPCPLAB015 11/13/2024 01/15/2025 View Archive
Pediatric Preventive Screening  CPCPLAB016 11/13/2024 01/15/2025 View Archive
Celiac Disease Testing  CPCPLAB017 11/13/2024 01/15/2025 View Archive
Helicobacter Pylori Testing  CPCPLAB018 11/20/2024 01/15/2025 View Archive
Thyroid Disease Testing  CPCPLAB019 11/13/2024 01/15/2025 View Archive
Cardiovascular Disease Risk Assessment  CPCPLAB020 11/13/2024 01/15/2025 View Archive
Diagnosis of Idiopathic Environmental Intolerance  CPCPLAB023 11/13/2024 01/15/2025 View Archive
Epithelial Cell Cytology in Breast Cancer Risk Assessment  CPCPLAB024 11/13/2024 01/15/2025 View Archive
Fecal Analysis in the Diagnosis of Intestinal Dysbiosis  CPCPLAB025 11/14/2024 01/15/2025 View Archive
Fecal Calprotectin Testing in Adults  CPCPLAB026 11/14/2024 01/15/2025 View Archive
Testing for Diagnosis of Active or Latent Tuberculosis  CPCPLAB027 11/20/2024 01/15/2025 View Archive
Immune Cell Function Assay  CPCPLAB028 12/19/2023 02/01/2024 View Archive
Intracellular Micronutrient Analysis  CPCPLAB029 11/14/2024 01/15/2025 View Archive
In Vitro Chemoresistance and Chemosensitivities Assays  CPCPLAB030 11/20/2024 01/15/2025 View Archive
Oral Cancer Screening and Testing  CPCPLAB032 11/14/2024 01/15/2025 View Archive
Diagnostic Testing of Influenza  CPCPLAB033 11/14/2024 01/15/2025 View Archive
Salivary Hormone Testing  CPCPLAB034 11/14/2024 01/15/2025 View Archive
Laboratory Testing for the Diagnosis of Inflammatory Bowel Disease  CPCPLAB035 11/15/2024 01/15/2025 View Archive
Serum Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases  CPCPLAB036 11/20/2024 01/15/2025 View Archive
Serum Tumor Markers for Malignancies  CPCPLAB037 11/14/2024 01/15/2025 View Archive
Urinary Tumor Markers for Bladder Cancer  CPCPLAB038 11/14/2024 01/15/2025 View Archive
Evaluation of Dry Eyes  CPCPLAB043 11/14/2024 01/15/2025 View Archive
Lyme Disease  CPCPLAB044 11/14/2024 01/15/2025 View Archive
Pathogen Panel Testing  CPCPLAB045 11/20/2024 01/15/2025 View Archive
Biomarkers for Myocardial Infarction and Chronic Heart Failure  CPCPLAB046 11/14/2024 01/15/2025 View Archive
Pancreatic Enzyme Testing for Acute Pancreatitis  CPCPLAB047 11/14/2024 01/15/2025 View Archive
Folate Testing  CPCPLAB048 11/14/2024 01/15/2025 View Archive
General Inflammation Testing  CPCPLAB049 11/14/2024 01/15/2025 View Archive
Urine Culture Testing for Bacteria  CPCPLAB050 11/14/2024 01/15/2025 View Archive
Diagnostic Testing of Common Sexually Transmitted Infections  CPCPLAB051 11/14/2024 01/15/2025 View Archive
Testing for Vector-Borne Infections  CPCPLAB052 11/14/2024 01/15/2025 View Archive
β-Hemolytic Streptococcus Testing  CPCPLAB053 11/20/2024 01/15/2025 View Archive
Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing  CPCPLAB055 11/15/2024 01/15/2025 View Archive
Gamma-glutamyl Transferase  CPCPLAB056 11/14/2024 01/15/2025 View Archive
Coronavirus Testing in the Outpatient Setting  CPCPLAB057 02/05/2024 03/15/2024 View Archive
Venous and Arterial Thrombosis Risk Testing  CPCPLAB058 11/14/2024 01/15/2025 View Archive
Diagnosis of Vaginitis  CPCPLAB059 11/20/2024 01/15/2025 View Archive
Testing for Alpha-1 Antitrypsin Deficiency  CPCPLAB061 11/14/2024 01/15/2025 View Archive
Identification of Microorganisms using Nucleic Acid Probes  CPCPLAB063 11/14/2024 01/15/2025 View Archive
Nerve Fiber Density Testing  CPCPLAB064 11/14/2024 01/15/2025 View Archive
Human Immunodeficiency Virus (HIV)  CPCPLAB065 11/14/2024 01/15/2025 View Archive
Testing of Homocysteine Metabolism-Related Conditions  CPCPLAB067 02/05/2024 03/15/2024 View Archive
Onychomycosis Testing  CPCPLAB068 11/14/2024 01/15/2025 View Archive
Immunohistochemistry  CPCPLAB069 02/01/2024 03/15/2024 View Archive
Prescription Medication and Illicit Drug Testing in the Outpatient Setting
 CPCPLAB070 11/14/2024 01/15/2025 View Archive
Colorectal Cancer Screening  CPCPLAB071 11/14/2024 01/15/2025 View Archive

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