CurrentBlue Cross Blue Shield - OklahomaPolicy CPCPLAB001

Flow Cytometry (immunophenotyping) reimbursement

Defines Blue Cross Blue Shield Oklahoma's reimbursement criteria, coding and billing rules for flow cytometry immunophenotyping of cell surface markers for covered members and providers.

Policy Summary

PayerBlue Cross Blue Shield - Oklahoma

PolicyFlow Cytometry (immunophenotyping) reimbursement

Policy CodePolicy CPCPLAB001

Change TypeNew policy

Effective DateNov 1, 2022

Next Review Date

Key ActionSubmit accurate documentation and provide additional documentation upon request for claim review against coverage, contracts, and coding policies.

SourceLink

POLICY UPDATE CHANGES

New policy

88184-88189, 86355-86367CPT/HCPCS code ranges referenced

Max 2Max units 88184

Max 35Max units 88185

Mutually exclusive88187-88189

2022-11-01Plan effective date

Reimbursement Criteria

Policy Summary

PayerBlue Cross Blue Shield - Oklahoma

PolicyFlow Cytometry (immunophenotyping) reimbursement

Policy CodePolicy CPCPLAB001

Change TypeNew policy

Effective DateNov 1, 2022

Next Review Date

Key ActionSubmit accurate documentation and provide additional documentation upon request for claim review against coverage, contracts, and coding policies.

SourceLink

On This Page

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.

Reimbursement criteria and coding limits

Flow cytometry immunophenotyping of cell surface markers may be reimbursable for the listed clinical indications and is not reimbursable for conditions not listed. Specific coding and unit limits apply.

ALL of the following

Clinical indications (ONE OR MORE of the following)
- Cytopenias, lymphomas, leukemia and lymphoproliferative disorders or myelodysplastic syndrome
- B-cell monitoring for immunosuppressive disorders
- T-cell monitoring for HIV infection and AIDS
- Mast cell neoplasms
- Paroxysmal nocturnal hemoglobinuria
- Post-operative monitoring of members who have undergone organ transplantation
- Plasma cell disorders
- Primary Immunodeficiencies (PIDs), and PIDs involving T, NK
- Hypercellular Hematolymphoid Disorders
- Chronic Lymphocytic Leukemia (CLL)
- Chronic Myeloproliferative Disorders (CMPD)
- Minimal Residual Disease (MRD)
- Molar pregnancy
- Primary Platelet Disorders, Non-neoplastic
- Red Cell and White Cell Disorders, Non-neoplastic
Not covered: Flow cytometry immunophenotyping is not reimbursable for any clinical condition not listed above.

ALL of the following

Use codes 88184-88189 for flow cytometric immunophenotyping for assessment of potential hematolymphoid neoplasia.
88184: Use for the first marker per specimen; reimbursable up to a maximum of 2 units per date of service.
88185: Use for each additional marker; reimbursable up to a maximum of 35 units per date of service.
In patients with a neoplasm with an established immunophenotype, subsequent tests should be limited to diagnostically relevant markers.
Codes 88187, 88188, and 88189 are mutually exclusive; do not use together in any combination and they are reimbursable as a single unit only.
Do not use codes 88187-88189 in conjunction with codes 86355, 86356, 86357, 86359, 86360, 86361, or 86367.

ALL of the following

Apply coding and unit limits per date of service as specified above.

Permitted Codes and Quantity Limits

Permitted flow cytometry and cell enumeration codesCPTCovered

88182	Cell marker study
88184	Flowcytometry/ tc 1 marker
88185	Flowcytometry/tc add-on
88187	Flowcytometry/read 2-8
88188	Flowcytometry/read 9-15
88189	Flowcytometry/read 16 & >
86355	B cells total count
86356	Mononuclear cell antigen
86357	Nk cells total count
86359	T cells total count

1–10 of 13

1/2

Max units for 88184

Code88184

DefinitionUsed for the first marker, per specimen

Maximum unitsMaximum 2 units per date of service

Max units for 88185

Code88185

DefinitionUsed for each additional marker (add-on)

Maximum unitsMaximum 35 units per date of service

Documentation and Claim Review Expectations

Documentation Required

Document accurately and respond to documentation requests

Providers are responsible for submission of accurate documentation of services performed and must submit claims using valid HIPAA-approved code combinations. Claims are subject to code edit protocols and review against benefit coverage, provider contract language, medical policies, clinical payment and coding policies, and coding software logic; upon request, providers are urged to submit any additional documentation.

Submit claims coded appropriately per industry standard coding guidelines (UB, AMA CPT, HCPCS, ICD-10, NDC, DRG, CMS NCCI, etc.).
Be prepared to provide additional documentation upon request to support claims during review.

Plan Documents and Governing Materials

Plan documents and precedence

Plan documents (examples)Certificates of Health Care Benefits, benefit booklets, Summary Plan Descriptions, and other coverage documents

Governing ruleIf a conflict arises between a CPCP and any plan document, the plan document will govern

Provider contractsIf a conflict arises between a CPCP and a provider contract, the provider contract will govern

BCBSOK discretionBCBSOK may use reasonable discretion interpreting and applying this policy; has final discretionary authority as provided under plan documents