Premera Blue Cross of Washington prior authorization 78454

Premera Blue Cross of Washington prior authorization for 78454: Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress

Code: 78454
Description: Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress
Source: Clinical Review by Code List PBCWA, Pg 432 Original policy

Premera Blue Cross of Washington prior authorization

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