0665U prior authorization | Anthem Blue Cross Blue Shield of California

0665U, Hepatology (metabolic dysfunction-associated steatohepatitis [MASH]), enzyme-linked immunosorbent assay (ELISA) for YKL40 and quantitative reverse transcription polymerase chain reaction (RT-qPCR) for miR-34a-5p, serum, algorithm reported as a single score for MASH activity and fibrosis, is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code

0665U

Description

Hepatology (metabolic dysfunction-associated steatohepatitis [MASH]), enzyme-linked immunosorbent assay (ELISA) for YKL40 and quantitative reverse transcription polymerase chain reaction (RT-qPCR) for miR-34a-5p, serum, algorithm reported as a single score for MASH activity and fibrosis

Source

California PPO Prior Authorization List, Pg 21 Original policy

Anthem Blue Cross Blue Shield of California prior authorization