0508U prior authorization | Blue Shield of California Promise Health Plan

0508U, Transplantation medicine, quantification of donor-derived cell-free dna using 40 single- nucleotide polymorphisms (snps), plasma and urine, initial evaluation reported as percentage of donor-derived cell-free dna with risk for active rejection, is on the Blue Shield of California Promise Health Plan Medi-Cal prior authorization list. Not a coverage or referral decision.

Code: 0508U
Description: Transplantation medicine, quantification of donor-derived cell-free dna using 40 single- nucleotide polymorphisms (snps), plasma and urine, initial evaluation reported as percentage of donor-derived cell-free dna with risk for active rejection
Source: Medi-Cal Prior Authorization List, Pg 16 Original policy

Blue Shield of California Promise Health Plan prior authorization

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