0376U prior authorization | Anthem Blue Cross and Blue Shield Virginia

0376U, Oncology (prostate cancer), image analysis of at least 128 histologic features and clinical factors, prognostic algorithm determining the risk of distant metastases, and prost, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 0376U
Description: Oncology (prostate cancer), image analysis of at least 128 histologic features and clinical factors, prognostic algorithm determining the risk of distant metastases, and prost
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 6 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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