Comparative Genomic Hybridization (CGH)

Aetna covers CGH for fetuses with structural abnormalities on ultrasound/MRI, for pregnant women undergoing invasive prenatal diagnostic testing (amniocentesis or CVS), for analysis of fetal tissue after stillbirth (≥20 weeks), for histologically equivocal Spitzoid melanocytic neoplasms, and for children with congenital anomalies when the presentation is not syndrome-specific and specified major/minor malformation criteria are met. Key requirements/limits: only one CGH per lifetime; pediatric cases must be evaluated by a board‑certified/eligible geneticist or relevant specialist and expected to affect management; CGH is not covered for detection of balanced rearrangements, for melanoma diagnosis, for evaluation of ALPS, or when a diagnosis is apparent clinically.

"Diagnosing genetic abnormalities in children with congenital anomalies when ALL of the following criteria are met: the member's clinical presentation is not specific to a well-delineated genetic sy..."