81560 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

81560, Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party- induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 81560
Description: Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party- induced CD154+T-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score
Source: New Hampshire Precertification List, Pg 182 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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