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0578U prior authorization | Blue Cross Blue Shield Oklahoma

0578U, Oncology (cutaneous melanoma), RNA, gene expression profiling by (cid:85)(cid:72)(cid:68)(cid:79)(cid:31)(cid:87)(cid:76)(cid:80)(cid:72)(cid:3)(cid:84)(cid:51)(cid:38)(cid:53)(cid:3)(cid:82)(cid:73)(cid:3)(cid:20)(cid:19)(cid:3)(cid:74)(cid:72)(cid:81)(cid:72)(cid:86)(cid:3)(cid:11)(cid:27)(cid:3) content and 2 housekeeping), utilizing formalin-fixed paraffin- embedded (FFPE) tissue, algorithm reports a binary result, either low-risk or high-risk for sentinel lymph node metastasis and recurrence, is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.

Code
0578U
Description
Oncology (cutaneous melanoma), RNA, gene expression profiling by (cid:85)(cid:72)(cid:68)(cid:79)(cid:31)(cid:87)(cid:76)(cid:80)(cid:72)(cid:3)(cid:84)(cid:51)(cid:38)(cid:53)(cid:3)(cid:82)(cid:73)(cid:3)(cid:20)(cid:19)(cid:3)(cid:74)(cid:72)(cid:81)(cid:72)(cid:86)(cid:3)(cid:11)(cid:27)(cid:3) content and 2 housekeeping), utilizing formalin-fixed paraffin- embedded (FFPE) tissue, algorithm reports a binary result, either low-risk or high-risk for sentinel lymph node metastasis and recurrence
Source
2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 44 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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