Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing
This policy defines BCBS Oklahoma reimbursement criteria for laboratory testing related to fecal analysis for intestinal dysbiosis and testing/screening related to fecal microbiota transplantation (donor screening). It affects providers submitting claims to Blue Cross and Blue Shield of Oklahoma and applies per plan document limits.
Edited #1, #2, #3 to clarify that fecal microbiota transplantation testing is on the sample coming from the donor; #4.h edited for clarity.
Added codes 87076, 87077, 87081, 87106
Removed codes 82239, 82725, 82784, 83520, 83630, 87177, 87209, 87328, 87329, 87336
Added codes 82239, 82725, 82784, 83520, 83630, 87177, 87209, 87328, 87329, 87336 (in previous revision)
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