Anthem Blue Cross Blue Shield of California prior authorization 1160T

Anthem Blue Cross Blue Shield of California prior authorization for 1160T: Oncology (breast), augmentative algorithmic analysis of histomorphologic features in digitized hematoxylin and eosin stained slides from formalin-fixed paraffin-embedded (FFPE) breast cancer tissue, algorithm-derived parameters reported as 5-year and 10-year risks of distant metastasis, including digitization of glass microscope slides and hematoxylin and eosin staining of tissue sections, when performed [ArteraAI Breast Cancer test]

Code

1160T

Description

Oncology (breast), augmentative algorithmic analysis of histomorphologic features in digitized hematoxylin and eosin stained slides from formalin-fixed paraffin-embedded (FFPE) breast cancer tissue, algorithm-derived parameters reported as 5-year and 10-year risks of distant metastasis, including digitization of glass microscope slides and hematoxylin and eosin staining of tissue sections, when performed [ArteraAI Breast Cancer test]

Source

California PPO Prior Authorization List, Pg 19 Original policy

Anthem Blue Cross Blue Shield of California prior authorization