Concert Genetic Testing: General Approach to Genetic and Molecular Testing

This policy covers genetic and molecular testing to detect genomic, transcriptional, proteomic, and epigenetic alterations—including germline and somatic testing, prenatal/preconception and preimplantation testing, hereditary cancer and multi-gene panels, tumor molecular analysis (including ctDNA/liquid biopsy), cytogenetics, and related algorithmic tests—when used for prevention, diagnosis, or treatment. It applies to patients with clinical indications such as known familial pathogenic variants, confirmed neoplasms or suspected inherited disorders, pregnancy evaluation, or when clinical criteria warrant broader panel testing, and recommends genetic counseling by clinicians with genetics expertise; targeted single‑variant testing is limited to a single known pathogenic/likely pathogenic familial variant. Tests are not covered when lacking demonstrated clinical validity or utility, for multifactorial disease prediction without clear benefit, for testing minors for adult‑onset conditions, for routine testing of variants of uncertain significance in relatives, or when the test is investigational or governed by other specific policies.