Prior Auth Required

81504 - Oncology (tissue of origin), microarray 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 / ServiceOncology (tissue of origin), microarray Prior Authorization Required Genetic Testing Submit online review with Carelon at
Procedure / Service Description

of 23 genes, utilizing whole peripheral Authorization: History and Physical, - albumin), utilizing serum, algorithm reported as a risk score 81504 Oncology (tissue of origin), microarray Prior Authorization Required Genetic Testing Submit online review with Carelon at gene expression profiling of > 2000 genes, www.providerportal.com. WA PLAN utilizing formalin-fixed paraffin-embedded MEMBERS ONLY: No prior authorization

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.