0576U prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

0576U, Transplantation medicine (liver allograft rejection), quantitative donor-derived cell- free DNA (cfDNA) by whole genome next- generation sequencing, plasma and mRNA gene express, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 0576U
Description: Transplantation medicine (liver allograft rejection), quantitative donor-derived cell- free DNA (cfDNA) by whole genome next- generation sequencing, plasma and mRNA gene express
Source: New Hampshire Precertification List, Pg 62 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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