Premera Blue Cross of Washington prior authorization 81431
Premera Blue Cross of Washington prior authorization for 81431: Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 genes These criteria do not imply or guarantee approval.
- Code
- 81431
- Description
- Hearing loss (eg, nonsyndromic hearing loss, Usher syndrome, Pendred syndrome); duplication/deletion analysis panel, must include copy number analyses for STRC and DFNB1 deletions in GJB2 and GJB6 genes These criteria do not imply or guarantee approval.
- Source
- Clinical Review by Code List PBCWA, Pg 484 Original policy