Blue Cross and Blue Shield of Montana prior authorization 81350

Blue Cross and Blue Shield of Montana prior authorization for 81350: Ugt1A1 (Udp Glucuronosyltransferase 1 Family Polypeptide A1) (Eg Drug Metabolism Hereditary Unconjugated Hyperbilirubinemia [Gilbert Syndrome]) Gene Analysis Common Variants (Eg *28 *36 *37)

Code: 81350
Description: Ugt1A1 (Udp Glucuronosyltransferase 1 Family Polypeptide A1) (Eg Drug Metabolism Hereditary Unconjugated Hyperbilirubinemia [Gilbert Syndrome]) Gene Analysis Common Variants (Eg *28 *36 *37)
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 128 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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