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Premera Blue Cross of Washington prior authorization 0333U

Premera Blue Cross of Washington prior authorization for 0333U: Oncology (liver), surveillance for hepatocellular carcinoma (HCC) in high-risk patients, analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement of serum of AFP/AFP-L3 and oncoprotein des-gamma-carboxy- prothrombin (DCP), algorithm reported as normal or abnormal result These criteria do not imply or guarantee approval.

Code
0333U
Description
Oncology (liver), surveillance for hepatocellular carcinoma (HCC) in high-risk patients, analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement of serum of AFP/AFP-L3 and oncoprotein des-gamma-carboxy- prothrombin (DCP), algorithm reported as normal or abnormal result These criteria do not imply or guarantee approval.
Source
Clinical Review by Code List PBCWA, Pg 67 Original policy

Premera Blue Cross of Washington prior authorization

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