81542 prior authorization | Anthem Blue Cross and Blue Shield Virginia

81542, Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk s, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 81542
Description: Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk s
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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