0513U prior authorization | Blue Shield of California Promise Health Plan

0513U, Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (msi) and homologous recombination deficiency (hrd) status, formalin-fixed paraffin-embedded (ffpe) tissue, reported as increased or decreased probability of each biomarker, is on the Blue Shield of California Promise Health Plan Medi-Cal prior authorization list. Not a coverage or referral decision.

Code

0513U

Description

Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (msi) and homologous recombination deficiency (hrd) status, formalin-fixed paraffin-embedded (ffpe) tissue, reported as increased or decreased probability of each biomarker

Source

Medi-Cal Prior Authorization List, Pg 16 Original policy

Blue Shield of California Promise Health Plan prior authorization