78815 prior authorization | Premera Blue Cross of Washington

78815, Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh 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: 78815
Description: Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 435 Original policy

Premera Blue Cross of Washington prior authorization

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