Concert Genetic Testing: Lung Disorders

This policy covers genetic and molecular testing for lung disorders—primarily SERPINA1 (alpha‑1 antitrypsin) testing (common variant analysis, sequencing/deletion‑duplication), multi‑gene panels, and donor‑derived cell‑free DNA (dd‑cfDNA) assays for noninvasive monitoring of lung transplant rejection—for patients with suspected AATD (e.g., low AAT levels, early‑onset or unexplained emphysema, bronchiectasis, or at‑risk family members) and for post‑lung transplant recipients. Coverage is limited to the specific assays/providers and CPT codes listed, requires documented clinical criteria and qualified ordering (transplant‑affiliated physicians for dd‑cfDNA), restricts dd‑cfDNA to post‑transplant patients not tested within the prior 12 months, and considers other indications or emerging assays investigational or subject to prior authorization.

"Genetic testing to diagnose alpha-1 antitrypsin deficiency (AATD)."