Genetic Testing for Reproductive Carrier Screening and Prenatal Diagnosis - (0514)

Cigna covers reproductive carrier and prenatal genetic testing only for specified clinical indications — e.g., familial variant testing; targeted CF, SMA, and hemoglobinopathy carrier testing; Ashkenazi Jewish panels; PGT‑M/PGT‑SR for severe monogenic/structural disorders; sequencing‑based NIPT for trisomies 13/18/21 in viable singleton or twin ≥10 weeks; and invasive prenatal testing for familial pathogenic variants or abnormal ultrasound — and excludes routine expanded population carrier panels (especially ≥15 genes), most expanded NIPT uses (microdeletions, rare autosomal trisomies, single‑gene NIPT, vanishing twin/higher‑order gestations), PGT for nonmedical traits or polygenic risk, MTHFR and specified single‑gene tests for recurrent loss, sperm DNA integrity assays, and other noncovered CPTs. Coverage requires meeting the policy’s clinical criteria (testing not previously performed, documented parental carrier/family history or affected relative, and that results will impact management), appropriate ICD‑10 coding, pre‑ and post‑test genetic counseling, and confirmatory invasive testing for positive NIPT results.