Concert Genetic Testing: Cardiac Disorders

This policy covers genetic testing for cardiac disorders—including targeted and multigene panels and gene expression/cell-free DNA testing post–heart transplant—to identify pathogenic or likely pathogenic variants in individuals with suspected hereditary arrhythmias, cardiomyopathies, congenital heart defects, unexplained sudden cardiac arrest/death, relevant family history, or for cascade testing of affected probands and at‑risk relatives. Coverage is limited to the policy’s specified clinical criteria (often applicable only for individuals >14 years), requires appropriate panel CPT coding and often involvement of a cardiac genetics expert, and many comprehensive multigene panels are investigational and not covered for indications outside those listed.

"Genetic testing for individuals with a clinical diagnosis suggestive of a hereditary arrhythmia to identify pathogenic or likely pathogenic variants."