0376U prior authorization | Anthem Blue Cross Blue Shield of Georgia

0376U, Oncology (prostate cancer), image analysis of at least 128 histologic features and clinical factors, prognostic algorithm determining the risk of distant metastases, and prost, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 0376U
Description: Oncology (prostate cancer), image analysis of at least 128 histologic features and clinical factors, prognostic algorithm determining the risk of distant metastases, and prost
Source: Standard Local Prior Authorization Code List, Pg 109 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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