0164U prior authorization | Anthem Blue Cross and Blue Shield Virginia

0164U, Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti-CdtB and anti- vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 0164U
Description: Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti-CdtB and anti- vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 3 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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