0020M prior authorization | Blue Cross and Blue Shield of Montana

0020M, Oncology (central nervous system), analysis of 30000 DNA methylation loci by methylation array, utilizing DNA extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 0020M
Description: Oncology (central nervous system), analysis of 30000 DNA methylation loci by methylation array, utilizing DNA extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 166 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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