81541 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
81541, Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease-specific mortality risk score, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 81541
- Description
- Oncology (prostate), mRNA gene expression profiling by real-time RT-PCR of 46 genes (31 content and 15 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a disease-specific mortality risk score
- Source
- New Hampshire Precertification List, Pg 181 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization