Premera Blue Cross of Washington prior authorization 78472

Premera Blue Cross of Washington prior authorization for 78472: Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing These criteria do not imply or guarantee approval.

Code: 78472
Description: Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 432 Original policy

Premera Blue Cross of Washington prior authorization

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