Non-Invasive Fetal Membranes Rupture Tests

Aetna considers the Biobeat Monitoring Platform, vaginal microbiome profiling for preterm ROM, fetal membrane imaging techniques (e.g., fusion MRI, MR elastography, optical coherence elastography/ tomography, shear wave elastography, ultrasonography) for detecting preterm ROM, and functional placental MRI for infection/inflammation in preterm premature ROM to be experimental/investigational and therefore excluded from coverage. The key requirement is that these interventions are not covered because their effectiveness has not been established.

"No specific documentation requirements or medical necessity documentation checklist is provided in this CPB."

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