Premera Blue Cross of Washington prior authorization 81522
Premera Blue Cross of Washington prior authorization for 81522: Oncology (breast), MRNA, gene expression profiling by RT-PCR OF 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score These criteria do not imply or guarantee approval.
- Code
- 81522
- Description
- Oncology (breast), MRNA, gene expression profiling by RT-PCR OF 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence risk score These criteria do not imply or guarantee approval.
- Source
- Clinical Review by Code List PBCWA, Pg 495 Original policy