0417U prior authorization | Anthem Blue Cross and Blue Shield Nevada

0417U, Rare diseases (constitutional/heritable disorders), whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis, nuclear-encoded mitochondrial gene a, is on the Anthem Blue Cross and Blue Shield Nevada prior authorization list. Not a coverage or referral decision.

Code: 0417U
Description: Rare diseases (constitutional/heritable disorders), whole mitochondrial genome sequence with heteroplasmy detection and deletion analysis, nuclear-encoded mitochondrial gene a
Source: Nevada Prior Authorization List, Pg 122 Original policy

Anthem Blue Cross and Blue Shield Nevada prior authorization

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