KidneyIntelX and KidneyIntelX.dkd Testing

This policy covers KidneyIntelX and KidneyIntelX.dkd, a CLIA‑certified laboratory blood‑based prognostic test that combines biomarkers, genetics, and EHR data to assess risk of progressive kidney function decline in adults with type 2 diabetes and early‑stage CKD (stages 1–3b). Coverage is limited to one lifetime test ordered by the treating clinician when results will inform therapeutic or prognostic management—applicable to adults >21 with eGFR 30–59 mL/min/1.73 m² or eGFR ≥60 with uACR ≥30 mg/g—and excludes patients ≤21, those with eGFR <30, ESRD or on renal replacement, pregnant or currently hospitalized patients, tests ordered/performed outside provider or CLIA requirements, and use as a screening or stand‑alone diagnostic.

"Single lifetime test to assess risk of progressive decline in kidney function in patients >21 years with type 2 diabetes and existing early-stage chronic kidney disease (CKD stages 1–3b) when resul..."