81170 prior authorization | Anthem Blue Cross and Blue Shield Virginia
81170, ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.
- Code
- 81170
- Description
- ABL1 (ABL proto-oncogene 1, non-receptor tyrosine kinase) (eg, acquired imatinib tyrosine kinase inhibitor resistance), gene analysis, variants in the kinase domain
- Source
- Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 32 Original policy
Anthem Blue Cross and Blue Shield Virginia prior authorization