0493U prior authorization | Premera Blue Cross of Washington

0493U, Transplantation medicine, quantification of donor-derived cell-free DNA (cfDNA) using next-generation sequencing, plasma, reported as percentage of donor-derived cell-free DNA, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 0493U
Description: Transplantation medicine, quantification of donor-derived cell-free DNA (cfDNA) using next-generation sequencing, plasma, reported as percentage of donor-derived cell-free DNA
Source: Clinical Review by Code List PBCWA, Pg 99 Original policy

Premera Blue Cross of Washington prior authorization

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