81354 prior authorization | Premera Blue Cross of Washington

81354, Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (OGM), is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 81354
Description: Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (OGM)
Source: Clinical Review by Code List PBCWA, Pg 477 Original policy

Premera Blue Cross of Washington prior authorization

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