0424U prior authorization | Premera Blue Cross of Washington

0424U, Oncology (prostate), exosome-based analysis of 53 small noncoding RNAs by quantitative reverse transcription polymerase chain reaction urine, reported as no molecular evidence, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 0424U
Description: Oncology (prostate), exosome-based analysis of 53 small noncoding RNAs by quantitative reverse transcription polymerase chain reaction urine, reported as no molecular evidence
Source: Clinical Review by Code List PBCWA, Pg 83 Original policy

Premera Blue Cross of Washington prior authorization

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