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Prenatal Genetic Testing Medical Policy Update Effective February 15, 2023

Audience: Maternal and Fetal Medicine, Reproductive Endocrinology/Infertility

Excellus BlueCross BlueShield works to ensure that the development of corporate medical policies occurs through an open, collaborative process. We encourage participating providers to become actively involved in medical policy development. Each month, draft policies are available on our website for review and comment here. Providers now have the capability of attaching supporting documentation related to their comments.

The following updated medical policy has been reviewed and was approved on October 20, 2022, by the Corporate Medical Policy Committee, including practitioner representatives from all Health Plan service regions.

Corporate Medical Policy #4.01.03—Prenatal Genetic Testing has been updated to be consistent with recommendations from The American College of Obstetricians and Gynecologists, The American College of Medical Genomics, and American Society for Reproductive Medicine. This updated policy will be effective February 15, 2023. The policy applies to all lines of business and to the services of all practitioners and facilities.

The updated policy imposes limitations to the criteria for preimplantation genetic testing, in accordance with societal guidelines.

The rationale section of the medical policy provides information related to the Health Plan’s change in coverage criteria is based on our assessment of peer-reviewed literature and professional society recommendations.

These services are subject to audit and policy updates at the Health Plan’s discretion. Access the individual policies here.

If you have any questions regarding this policy, please contact your Provider Relations representative.

Thank you for the quality of care and service that you provide to our members.

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