Premera Blue Cross of Washington prior authorization 0667U

Premera Blue Cross of Washington prior authorization for 0667U: Inborn error of metabolism (primary mitochondrial disease), determination of fibroblast growth factor 21 (FGF21) concentration by enzyme-linked immunosorbent assay (ELISA), serum or plasma, diagnostic quantitative result These criteria do not imply or guarantee approval.

Code: 0667U
Description: Inborn error of metabolism (primary mitochondrial disease), determination of fibroblast growth factor 21 (FGF21) concentration by enzyme-linked immunosorbent assay (ELISA), serum or plasma, diagnostic quantitative result These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 144 Original policy

Premera Blue Cross of Washington prior authorization

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