0118U prior authorization | Blue Shield of California Promise Health Plan

0118U, Transplantation medicine, quantification of donor-derived cell-free DNA using whole genome next-generation sequencing, plasma, reported as percentage of donor-derived cell- free DNA in the total cell-free DNA, is on the Blue Shield of California Promise Health Plan Medi-Cal prior authorization list. Not a coverage or referral decision.

Code: 0118U
Description: Transplantation medicine, quantification of donor-derived cell-free DNA using whole genome next-generation sequencing, plasma, reported as percentage of donor-derived cell- free DNA in the total cell-free DNA
Source: Medi-Cal Prior Authorization List, Pg 12 Original policy

Blue Shield of California Promise Health Plan prior authorization

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