Prior Auth Required

0576U - Transplantation medicine (liver allograft Prior Authorization Required Genetic Testing Submit online review with Carelon at

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServiceTransplantation medicine (liver allograft Prior Authorization Required Genetic Testing Submit online review with Carelon at
Procedure / Service Description

profiling by RT-PCR of 4 genes (miR-122, Authorization: History and Physical, - control), serum, algorithm reported as risk report. of liver allograft rejection 0576U Transplantation medicine (liver allograft Prior Authorization Required Genetic Testing Submit online review with Carelon at rejection), quantitative donor-derived cell- www.providerportal.com. For Prior free DNA (cfDNA) by whole genome next- Authorization: History and Physical,

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.