Premera Blue Cross of Washington prior authorization 77049

Premera Blue Cross of Washington prior authorization for 77049: Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral

Code: 77049
Description: Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral
Source: Clinical Review by Code List PBCWA, Pg 418 Original policy

Premera Blue Cross of Washington prior authorization

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