81465 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

81465, Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 81465
Description: Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed
Source: New Hampshire Precertification List, Pg 178 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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