75580 prior authorization | Premera Blue Cross of Washington

75580, Noninvasive estimate of coronary fractional flow reserve derived from augmentative software analysis of the data set from a coronary computed tomography angiography, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 75580
Description: Noninvasive estimate of coronary fractional flow reserve derived from augmentative software analysis of the data set from a coronary computed tomography angiography
Source: Clinical Review by Code List PBCWA, Pg 412 Original policy

Premera Blue Cross of Washington prior authorization

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