81313 prior authorization | Blue Cross and Blue Shield of Montana

81313, Pca3/Klk3 (Prostate Cancer Antigen 3 [Non-Carelon Protein Coding]/Kallikrein-Related Peptidase 3 [Prostate Specific Antigen]) Ratio (Eg Prostate Cancer), is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 81313
Description: Pca3/Klk3 (Prostate Cancer Antigen 3 [Non-Carelon Protein Coding]/Kallikrein-Related Peptidase 3 [Prostate Specific Antigen]) Ratio (Eg Prostate Cancer)
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 122 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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