81552 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

81552, Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT- PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin- embedded tissue, algorithm reported as risk of metastasis, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 81552
Description: Oncology (uveal melanoma), mRNA, gene expression profiling by real-time RT- PCR of 15 genes (12 content and 3 housekeeping), utilizing fine needle aspirate or formalin-fixed paraffin- embedded tissue, algorithm reported as risk of metastasis
Source: New Hampshire Precertification List, Pg 181 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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