81313 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
81313, PCA3/KLK3 (prostate cancer antigen 3 [non-protein coding]/kallikrein-related peptidase 3 [prostate specific antigen]) ratio (eg, prostate cancer), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 81313
- Description
- PCA3/KLK3 (prostate cancer antigen 3 [non-protein coding]/kallikrein-related peptidase 3 [prostate specific antigen]) ratio (eg, prostate cancer)
- Source
- New Hampshire Precertification List, Pg 166 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization