0417U prior authorization | Blue Cross Blue Shield Oklahoma
0417U, Rare Diseases (Constitutional/Heritable Disorders) Whole Mitochondrial Genome Sequence With Heteroplasmy Detection And Deletion Analysis Nuclear-Encoded Mitochondrial Gene Analysis Of 335 Nuclear Genes Including Sequence Changes Deletions Insertions And Copy Number Variants Analysis Blood Or Saliva Identification And Categorization Of Mitochondrial Disorder-Associated Genetic Variants, is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.
- Code
- 0417U
- Description
- Rare Diseases (Constitutional/Heritable Disorders) Whole Mitochondrial Genome Sequence With Heteroplasmy Detection And Deletion Analysis Nuclear-Encoded Mitochondrial Gene Analysis Of 335 Nuclear Genes Including Sequence Changes Deletions Insertions And Copy Number Variants Analysis Blood Or Saliva Identification And Categorization Of Mitochondrial Disorder-Associated Genetic Variants
- Source
- 2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 137 Original policy