Noninvasive Down Syndrome Screening

Covered: first‑trimester NT alone for multiple gestations; combined first‑trimester NT plus serum analytes (PAPP‑A + hCG); integrated/sequential/contingent screening that includes first‑trimester NT+PAPP‑A+hCG plus second‑trimester quad; standalone second‑trimester serum (quad) screening; and serum‑integrated screening (first‑trimester PAPP‑A+hCG plus second‑trimester quad) when NT is unavailable. Key requirements/exclusions: these tests are not medically necessary if chromosomal microarray or NIPT (cell‑free DNA) has been performed in the current pregnancy; NT testing must be done by credentialed operators with ongoing quality monitoring (eg, NTQR or FMF‑US); first‑trimester NT alone in singletons (unless fetal cystic hygroma), first‑trimester serum analytes alone, and nasal bone assessment are considered experimental/investigational and not covered.

"ICD-10 codes covered if selection criteria are met: Q90."