0113U prior authorization | Premera Blue Cross of Washington

0113U, Oncology (prostate), measurement of PCA3 and TMPRSS2-ERG in urine and PSA in serum following prostatic massage, by RNA amplification and fluorescence- based detection, algorithm reported as risk score, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 0113U
Description: Oncology (prostate), measurement of PCA3 and TMPRSS2-ERG in urine and PSA in serum following prostatic massage, by RNA amplification and fluorescence- based detection, algorithm reported as risk score
Source: Clinical Review by Code List PBCWA, Pg 29 Original policy

Premera Blue Cross of Washington prior authorization

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