0597U prior authorization | Premera Blue Cross of Washington

0597U, Oncology (breast), RNA expression profiling of 329 genes by targeted next- generation sequencing and 20 proteins by multiplex immunofluorescence, formalin- fixed paraffin-embedded (FFPE) tissue, algorithmic analyses to determine tumor- recurrence risk score, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 0597U
Description: Oncology (breast), RNA expression profiling of 329 genes by targeted next- generation sequencing and 20 proteins by multiplex immunofluorescence, formalin- fixed paraffin-embedded (FFPE) tissue, algorithmic analyses to determine tumor- recurrence risk score
Source: Clinical Review by Code List PBCWA, Pg 125 Original policy

Premera Blue Cross of Washington prior authorization

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