Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs)

This LCD covers outpatient gastrointestinal pathogen (GIP) multiplex NAAT panels with 11 or fewer targets for Medicare beneficiaries with acute diarrhea ≥7 days, persistent diarrhea 14–30 days, or acute diarrhea with severe signs/risk factors, and covers panels with 12+ targets for immunocompromised patients with acute or persistent diarrhea. Coverage excludes testing of asymptomatic patients, use of NAATs as a test-of-cure, repeat testing within seven days for the same episode, and more than one panel on the same date; labs must be CLIA-certified and medical records must document clinical indications and risk factors.

"GIP panels utilizing NAATs with 11 or fewer targets are medically reasonable and necessary for Medicare beneficiaries with acute diarrhea present for at least 7 days."

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