CG-LAB-22 Nucleic Acid Amplification Tests Using Algorithmic Analysis for the Diagnosis of Vaginitis

This policy addresses nucleic acid amplification tests (NAATs) that use algorithmic analysis to diagnose vaginitis, targeting bacterial vaginosis–associated bacteria, Trichomonas vaginalis, and/or Candida species. Coverage is medically necessary for individuals with symptoms of vaginitis, or for asymptomatic pregnant individuals who have a history of preterm birth; it is not medically necessary when these criteria are not met. Key limitations: testing is restricted to the above indications and is not covered for asymptomatic individuals without the specified pregnancy risk.

"Nucleic acid amplification testing for vaginitis (bacterial vaginosis-associated bacteria, Trichomonas vaginalis and/or Candida species) using algorithmic analysis is consideredmedically necessaryw..."

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