Concert Genetic Testing: Kidney Disorders

This policy covers genetic and molecular testing for inherited kidney disorders — including comprehensive NGS/exome or multi-gene panels for polycystic and other hereditary renal diseases, APOL1 risk genotyping — and peripheral donor‑derived cell‑free DNA (dd‑cfDNA) testing to detect and monitor kidney transplant rejection. Coverage is limited to specified clinical indications and populations (e.g., CKD of unknown cause meeting criteria such as onset <40 years, family history, syndromic features; individuals of African ancestry or relatives for APOL1 testing; post‑transplant patients for dd‑cfDNA), requires prior standard-of-care evaluation, is subject to frequency limits (dd‑cfDNA not covered if performed within 12 months), and excludes investigational or non‑listed uses.

"Genetic testing to identify the genetic cause in patients with suspected inherited kidney disorders (e."