75563 prior authorization | Premera Blue Cross of Washington

75563, Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 75563
Description: Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging
Source: Clinical Review by Code List PBCWA, Pg 410 Original policy

Premera Blue Cross of Washington prior authorization

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