Blue Shield of California Promise Health Plan prior authorization 0513U

Blue Shield of California Promise Health Plan prior authorization for 0513U: Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (msi) and homologous recombination deficiency (hrd) status, formalin-fixed paraffin-embedded (ffpe) tissue, reported as increased or decreased probability of each biomarker

Code

0513U

Description

Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (msi) and homologous recombination deficiency (hrd) status, formalin-fixed paraffin-embedded (ffpe) tissue, reported as increased or decreased probability of each biomarker

Source

Medi-Cal Prior Authorization List, Pg 16 Original policy

Blue Shield of California Promise Health Plan prior authorization