0255U prior authorization | Anthem Blue Cross Blue Shield of Colorado

0255U, Andrology (infertility), sperm-capacitation assessment of ganglioside GM1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of c, is on the Anthem Blue Cross Blue Shield of Colorado prior authorization list. Not a coverage or referral decision.

Code: 0255U
Description: Andrology (infertility), sperm-capacitation assessment of ganglioside GM1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of c
Source: Colorado Prior Authorization List, Pg 124 Original policy

Anthem Blue Cross Blue Shield of Colorado prior authorization

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