CG-LAB-17 Molecular Gastrointestinal Pathogen Panel (GIPP) Testing for Infectious Diarrhea in the Outpatient Setting

This policy addresses outpatient molecular gastrointestinal pathogen panel (GIPP) testing using multiplex PCR for infectious diarrhea. It is medically necessary only for limited panels with 5 targets or fewer when patients have community-acquired diarrhea lasting ≥7 days, travel-associated diarrhea of uncertain cause, or severe features/risk factors (e.g., fever, bloody diarrhea/dysentery, dehydration, severe abdominal pain, or immunocompromised state); it is not medically necessary for individuals who do not meet these criteria.

"Multiplex PCR-based panel testing of gastrointestinal pathogens using limited panels involving 5 targets or less is consideredmedically necessaryfor the following indications:Individuals suspected ..."

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