81277 prior authorization | Premera Blue Cross of Washington

81277, Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss- of-heterozygosity variants for chromosomal abnormalities 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: 81277
Description: Cytogenomic neoplasia (genome-wide) microarray analysis, interrogation of genomic regions for copy number and loss- of-heterozygosity variants for chromosomal abnormalities These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 460 Original policy

Premera Blue Cross of Washington prior authorization

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