0164U prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

0164U, Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti- CdtB and anti-vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative results, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 0164U
Description: Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti- CdtB and anti-vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative results
Source: New Hampshire Precertification List, Pg 25 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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