Cytogenetic Studies

Medicare covers cytogenetic studies when reasonable and necessary for specified conditions including prenatal genetic disorders (e.g., Down syndrome), failure of sexual development, chronic myelogenous leukemia, acute leukemias (specified FAB subtypes), and myelodysplasia. Coverage requires documentation of medical necessity consistent with Medicare Benefit Policy Chapter 15 §20.1; tests not meeting medical necessity are not covered.

"Cytogenetic studies are covered when reasonable and necessary to diagnose or manage genetic disorders in a fetus (prenatal genetic testing), e."

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