81174 prior authorization | Premera Blue Cross of Washington

81174, AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant 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: 81174
Description: AR (androgen receptor) (eg, spinal and bulbar muscular atrophy, Kennedy disease, X chromosome inactivation) gene analysis; known familial variant These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 440 Original policy

Premera Blue Cross of Washington prior authorization

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