CG-LAB-10 Zika Virus Testing

- Policy addresses Zika virus laboratory testing: Zika RNA real-time RT-PCR (on serum, urine, combined serum/urine, cerebrospinal fluid, amniotic fluid, or saliva) and Zika virus IgM with neutralizing antibody titers (PRNT) for serum. - Coverage: Medically necessary when testing follows the most current CDC recommendations, with updates effective as of the CDC’s stated date; not medically necessary when testing is outside CDC guidance. - Key conditions/limitations: Probable exposure includes residence in or travel to areas with ongoing Zika transmission, or epidemiologic linkage (e.g., sexual contact, in utero/perinatal exposure, blood transfusion, or organ transplantation).

"Zika virus testing is consideredmedically necessaryfor individuals in accordance with the recommendations of the U."

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