0494U prior authorization | Premera Blue Cross of Washington

0494U, Red blood cell antigen (fetal RhD gene analysis), next-generation sequencing of circulating cell-free DNA (cfDNA) of blood in pregnant individuals known to be RhD negative, reported as positive or negative 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: 0494U
Description: Red blood cell antigen (fetal RhD gene analysis), next-generation sequencing of circulating cell-free DNA (cfDNA) of blood in pregnant individuals known to be RhD negative, reported as positive or negative These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 99 Original policy

Premera Blue Cross of Washington prior authorization

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