Blue Cross and Blue Shield of Montana prior authorization 0454U

Blue Cross and Blue Shield of Montana prior authorization for 0454U: Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping

Code: 0454U
Description: Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 219 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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