0486U prior authorization | Premera Blue Cross of Washington

0486U, Oncology (pan-solid tumor), next- generation sequencing analysis of tumor methylation markers present in cell-free circulating tumor DNA, algorithm reported as quantitative measurement of methylation as a correlate of tumor fraction 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: 0486U
Description: Oncology (pan-solid tumor), next- generation sequencing analysis of tumor methylation markers present in cell-free circulating tumor DNA, algorithm reported as quantitative measurement of methylation as a correlate of tumor fraction These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 96 Original policy

Premera Blue Cross of Washington prior authorization

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