81172 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
81172, AFF2 (ALF transcription elongation factor 2 [FMR2]) (eg, fragile X intellectual disability 2 [FRAXE]) gene analysis; characterization of alleles (eg, expanded size and methylation status), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 81172
- Description
- AFF2 (ALF transcription elongation factor 2 [FMR2]) (eg, fragile X intellectual disability 2 [FRAXE]) gene analysis; characterization of alleles (eg, expanded size and methylation status)
- Source
- New Hampshire Precertification List, Pg 156 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization