Respiratory Pathogen Nucleic Acid Detection Testing – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare considers outpatient respiratory pathogen multiplex panels of six or more targets unproven and not medically necessary (excluded), though guideline-identified high‑risk or hospitalized populations (e.g., hematology/oncology, transplant, ICU, immunocompromised) may be appropriate candidates for testing. Coverage is determined by the member-specific benefit plan (the plan document governs), testing must be justified by clinical context and interpreted with awareness of test limitations, and no specific documentation checklist or FDA-approval guarantee is provided.

"No explicit covered indications are listed in this policy."

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