Premera Blue Cross of Washington prior authorization 0004M

Premera Blue Cross of Washington prior authorization for 0004M: Scoliosis, DNA analysis of 53 single nucleotide polymorphisms (SNPs), using saliva, prognostic algorithm reported as a risk score These criteria do not imply or guarantee approval.

Code: 0004M
Description: Scoliosis, DNA analysis of 53 single nucleotide polymorphisms (SNPs), using saliva, prognostic algorithm reported as a risk score These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 12 Original policy

Premera Blue Cross of Washington prior authorization

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