Prior Auth Required

0237U - Proprietary tests (U codes/M codes) – General Selected examples: ; ; ; , , All

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceProprietary tests (U codes/M codes) – General Selected examples: ; ; ; , , All
Procedure / Service Description

Service Category Benefit/Description Codes Requiring Authorization Member Program* - Thiopurine S methyltransferase (enzyme) 84433 All Cologuard / FIT DNA 81528 All Proprietary tests (U codes/M codes) – General Selected examples: 0001U–0179U; 0203U–0258U; 0286U–0300U; 0012M, 0013M, 0016M All Platelet antigen genotyping (HPA) 81105–81112 All Selected pharmacogenetic/hematology genes (condensed) 81120, 81121, 81175–81176, 81230–81232, 81238, 81247–81249, 81258–81259, 81269, 81283, 81328, 81334–81335, 81346, All

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.