Commercial Outpatient Prior Authorization — ASO Medical Surgical Procedure Code List
A listing of outpatient procedure and molecular/genetic codes that may require prior authorization for ASO commercial members of Blue Cross Blue Shield of New Mexico and instructions for initiating prior authorization; applies to providers submitting requests to BCBSNM and Carelon-managed services.
Multiple molecular genetic and U-code procedures (e.g., 81457–81464, 0420U–0423U) were added with an effective date of 04/01/2024.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.