Genetic Testing for Neurological Disorders – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers multi-gene targeted panels (≥5 genes) only to establish a genetic cause of congenital/metabolic myopathy, ataxia, peripheral neuropathy, hereditary spastic paraplegia, or muscular dystrophy, and considers comprehensive cross-category panels and WES/WGS not covered under this policy. Coverage requires the patient to have signs/symptoms of a heritable neurological disorder with results expected to directly impact management and the test must be ordered by or in consultation with a medical geneticist, developmental pediatrician, or neuromuscular/neurogenetics specialist with appropriate documentation.

"This policy applies to UnitedHealthcare Commercial and Individual Exchange benefit plans; application to Medicare Advantage plans may occur only in the absence of CMS NCDs/LCDs and at the MAO's dis..."

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