0114U prior authorization | Blue Cross and Blue Shield of Montana

0114U, Gastroenterology (Barrett’S Esophagus) Vim And Ccna1 Methylation Analysis Esophageal Cells Algorithm Reported As Likelihood For Barrett’S Esophagus, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 0114U
Description: Gastroenterology (Barrett’S Esophagus) Vim And Ccna1 Methylation Analysis Esophageal Cells Algorithm Reported As Likelihood For Barrett’S Esophagus
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 176 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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