Anthem Blue Cross Blue Shield of California prior authorization 0576U

Anthem Blue Cross Blue Shield of California prior authorization for 0576U: Transplantation medicine (liver allograft rejection), quantitative donor-derived cell-free DNA (cfDNA) by whole genome next generation sequencing, plasma and mRNA gene expression profiling by multiplex real-time PCR of 56 genes, whole blood, combined algorithm reported as a rejection risk score

Code: 0576U
Description: Transplantation medicine (liver allograft rejection), quantitative donor-derived cell-free DNA (cfDNA) by whole genome next generation sequencing, plasma and mRNA gene expression profiling by multiplex real-time PCR of 56 genes, whole blood, combined algorithm reported as a rejection risk score
Source: California PPO Prior Authorization List, Pg 154 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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