81542 prior authorization | Anthem Blue Cross Blue Shield of Georgia
81542, Oncology (prostate), mRNA, microarray gene expression profiling of 22 content genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as metastasis risk score, is on the Anthem Blue Cross Blue Shield of Georgia 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 score
- Source
- Standard Local Prior Authorization Code List, Pg 53 Original policy
Anthem Blue Cross Blue Shield of Georgia prior authorization