MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

This policy provides limited outpatient coverage for molecular syndromic infectious disease panels when testing is clinically indicated, performed per intended use (including required parallel testing), and will impact management as supported by peer-reviewed evidence. Expanded panels (≥6 targets) and specific panel types (RP, PNP, GI, UG/AG, ME, BSI, UTI) have additional specialist, severity, sample-type, and documentation requirements; certain uses (test of cure, duplicate testing within 14 days, home-use panels) are not covered.

"Molecular syndromic infectious disease panel testing is covered when the patient has a clinical indication for infectious disease testing and all general coverage criteria in this policy are met."

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