Concert Genetic Testing: Prenatal Cell-Free DNA Testing

This policy covers prenatal cell‑free DNA (cfDNA/NIPT) screening for fetal aneuploidies (trisomy 21, 18, 13), sex chromosome aneuploidies and fetal sex, select noninvasive fetal antigen/RhD tests, and maternal serum screening (first/second trimester or integrated) for singleton pregnancies and for twin pregnancies when no prior cfDNA has been performed. cfDNA is a screening—not diagnostic—test that requires pretest counseling about false‑positive risk and confirmatory diagnostic testing for positive/high‑risk results; expanded applications (microdeletions/microduplications, single‑gene disorder screening), twin‑zygosity prediction, testing in triplet+ gestations, simultaneous cfDNA with maternal serum screening, testing with a vanishing twin, and fetal‑sex‑only testing are investigational or not medically necessary, and MSS is limited to one test per pregnancy.

"Screening for fetal autosomal aneuploidy (trisomy 21, trisomy 13, trisomy 18) using placental cell-free DNA in maternal serum"