0512U prior authorization | Blue Shield of California Promise Health Plan

0512U, Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (msi) status, formalin-fixed paraffin- embedded (ffpe) tissue, reported as increased or decreased probability of msi-high (msi-h), is on the Blue Shield of California Promise Health Plan Medi-Cal prior authorization list. Not a coverage or referral decision.

Code: 0512U
Description: Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (msi) status, formalin-fixed paraffin- embedded (ffpe) tissue, reported as increased or decreased probability of msi-high (msi-h)
Source: Medi-Cal Prior Authorization List, Pg 16 Original policy

Blue Shield of California Promise Health Plan prior authorization

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