0158U prior authorization | Premera Blue Cross of Washington
0158U, MLH1 (MUTL HOMOLOG 1) (EG, hereditary non-polyposis colorectal cancer, lynch syndrome) mrna sequence analysis (list separately in addition to code for primary procedure), is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.
- Code
- 0158U
- Description
- MLH1 (MUTL HOMOLOG 1) (EG, hereditary non-polyposis colorectal cancer, lynch syndrome) mrna sequence analysis (list separately in addition to code for primary procedure)
- Source
- Clinical Review by Code List PBCWA, Pg 33 Original policy