0017M prior authorization | Anthem Blue Cross and Blue Shield Virginia

0017M, Oncology (diffuse large B-cell lymphoma [DLBCL]), mRNA, gene expression profiling by fluorescent probe hybridization of 20 genes, formalin-fixed paraffin-embedded tissue, algo, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 0017M
Description: Oncology (diffuse large B-cell lymphoma [DLBCL]), mRNA, gene expression profiling by fluorescent probe hybridization of 20 genes, formalin-fixed paraffin-embedded tissue, algo
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 2 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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