81542 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

81542, Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin- embedded tissue, algorithm reported as metastasis risk score, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 81542
Description: Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin- embedded tissue, algorithm reported as metastasis risk score
Source: New Hampshire Precertification List, Pg 181 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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