Prior Auth Required

81415 - Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / ServiceExome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis
Procedure / Service Description

correction and anatomical localization imaging; whole body - 81217 BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; known familial variant 81415 Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis 81416 Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure)

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.