81504 prior authorization | Anthem Blue Cross Blue Shield of Colorado

81504, Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity s, is on the Anthem Blue Cross Blue Shield of Colorado prior authorization list. Not a coverage or referral decision.

Code: 81504
Description: Oncology (tissue of origin), microarray gene expression profiling of > 2000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity s
Source: Colorado Prior Authorization List, Pg 106 Original policy

Anthem Blue Cross Blue Shield of Colorado prior authorization

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