0631U prior authorization | Premera Blue Cross of Washington

0631U, Oncology (solid tumor), DNA, sequence analysis of 15 genes including BRCA1 and BRCA2 for identification of clonal hematopoiesis, blood, reported as tumor- derived or nontumor-derived, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 0631U
Description: Oncology (solid tumor), DNA, sequence analysis of 15 genes including BRCA1 and BRCA2 for identification of clonal hematopoiesis, blood, reported as tumor- derived or nontumor-derived
Source: Clinical Review by Code List PBCWA, Pg 135 Original policy

Premera Blue Cross of Washington prior authorization

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