Premera Blue Cross of Washington prior authorization 0414U

Premera Blue Cross of Washington prior authorization for 0414U: Oncology (lung), augmentative algorithmic analysis of digitized whole slide imaging for 8 genes & KRAS G12C & PD-L1, if performed, formalin-fixed paraffin- embedded tissue report These criteria do not imply or guarantee approval.

Code: 0414U
Description: Oncology (lung), augmentative algorithmic analysis of digitized whole slide imaging for 8 genes & KRAS G12C & PD-L1, if performed, formalin-fixed paraffin- embedded tissue report These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 81 Original policy

Premera Blue Cross of Washington prior authorization

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