0046U prior authorization | Premera Blue Cross of Washington

0046U, FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia) internal tandem duplication (ITD) variants, quantitative These criteria do not imply or guarantee approval., is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 0046U
Description: FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia) internal tandem duplication (ITD) variants, quantitative These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 20 Original policy

Premera Blue Cross of Washington prior authorization

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