81522 prior authorization | Anthem Blue Cross and Blue Shield Virginia

81522, Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 81522
Description: Oncology (breast), mRNA, gene expression profiling by RT-PCR of 12 genes (8 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 37 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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