0114U prior authorization | Premera Blue Cross of Washington

0114U, Gastroenterology (Barrett's esophagus), VIM and CCNA1 methylation analysis, esophageal cells, algorithm reported as likelihood for Barrett's esophagus, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 0114U
Description: Gastroenterology (Barrett's esophagus), VIM and CCNA1 methylation analysis, esophageal cells, algorithm reported as likelihood for Barrett's esophagus
Source: Clinical Review by Code List PBCWA, Pg 29 Original policy

Premera Blue Cross of Washington prior authorization

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