81172 prior authorization | Anthem Blue Cross and Blue Shield Virginia

81172, AFF2 (ALF transcription elongation factor 2 [FMR2]) (eg, fragile X intellectual disability 2 [FRAXE]) gene analysis; characterization of alleles (eg, expanded size and methyla, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 81172
Description: AFF2 (ALF transcription elongation factor 2 [FMR2]) (eg, fragile X intellectual disability 2 [FRAXE]) gene analysis; characterization of alleles (eg, expanded size and methyla
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 32 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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