Anthem Blue Cross Blue Shield of Georgia prior authorization 0255U

Anthem Blue Cross Blue Shield of Georgia prior authorization for 0255U: Andrology (infertility), sperm-capacitation assessment of ganglioside GM1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score

Code: 0255U
Description: Andrology (infertility), sperm-capacitation assessment of ganglioside GM1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score
Source: Standard Local Prior Authorization Code List, Pg 137 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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