Premera Blue Cross of Washington prior authorization 81504

Premera Blue Cross of Washington prior authorization for 81504: Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores

Code: 81504
Description: Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores
Source: Clinical Review by Code List PBCWA, Pg 494 Original policy

Premera Blue Cross of Washington prior authorization

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