81224 prior authorization | Premera Blue Cross of Washington

81224, CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) 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: 81224
Description: CFTR (cystic fibrosis transmembrane conductance regulator) (eg, cystic fibrosis) gene analysis; intron 8 poly-T analysis (eg, male infertility) These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 449 Original policy

Premera Blue Cross of Washington prior authorization

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