Premera Blue Cross of Washington prior authorization 0665U

Premera Blue Cross of Washington prior authorization for 0665U: Hepatology (metabolic dysfunction- associated steatohepatitis [MASH]), enzyme-linked immunosorbent assay (ELISA) for YKL40 and quantitative reverse transcription polymerase chain reaction (RT- qPCR) for miR-34a-5p, serum, algorithm reported as a single score for MASH activity and fibrosis

Code: 0665U
Description: Hepatology (metabolic dysfunction- associated steatohepatitis [MASH]), enzyme-linked immunosorbent assay (ELISA) for YKL40 and quantitative reverse transcription polymerase chain reaction (RT- qPCR) for miR-34a-5p, serum, algorithm reported as a single score for MASH activity and fibrosis
Source: Clinical Review by Code List PBCWA, Pg 144 Original policy

Premera Blue Cross of Washington prior authorization

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