81168 prior authorization | Premera Blue Cross of Washington

81168, CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed 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: 81168
Description: CCND1/IGH (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 439 Original policy

Premera Blue Cross of Washington prior authorization

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