81490 prior authorization | Anthem Blue Cross and Blue Shield Virginia

81490, Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 81490
Description: Autoimmune (rheumatoid arthritis), analysis of 12 biomarkers using immunoassays, utilizing serum, prognostic algorithm reported as a disease activity score
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 36 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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