81520 prior authorization | Premera Blue Cross of Washington
81520, Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence risk score, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.
- Code
- 81520
- Description
- Oncology (breast), mRNA gene expression profiling by hybrid capture of 58 genes (50 content and 8 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a recurrence risk score
- Source
- Clinical Review by Code List PBCWA, Pg 495 Original policy