Nucleic acid sequencing-based testing of maternal plasma for trisomy 21 may be considered medically necessary in women with high-risk singleton pregnancies undergoing screening for trisomy 21 and are at a minimum of 10 weeks gestation and who meet at least ONE of the following criteria: Effective for dates of service prior to January 1, 2021: Vanadis NIPT of maternal plasma to screen for trisomy 21, 18 and 13 is considered investigational in all situations. Nucleic acid sequencing-based testing of maternal plasma for twin zygosity is considered investigational. Nucleic acid sequencing-based testing of maternal plasma for microdeletions is considered investigational.
Nucleic acid sequencing-based testing of maternal plasma for fetal sex chromosome aneuploidies is considered investigational. Nucleic acid sequencing-based testing of maternal plasma for trisomy 13 and/or 18, other than in the situations specified above, is considered investigational. Nucleic acid sequencing-based testing of maternal plasma for trisomy 21 is considered and investigational in women with high-order multiple gestation (i.e. Nucleic acid sequencing-based testing of maternal plasma for trisomy 21 is considered investigational for women with average-risk singleton or average-risk twin pregnancy. Parental balanced robertsonian translocation with increased risk of fetal trisomy 13 or trisomy 21Ĭoncurrent nucleic acid sequencing-based testing of maternal plasma for trisomy 13 and/or 18 may be considered medically necessary in women who are eligible for and are undergoing nucleic acid sequencing-based testing of maternal plasma for trisomy 21.Standard serum screening test positive for aneuploidy OR.History of previous pregnancy with a trisomy OR.Fetal ultrasonographic findings indicating increased risk of aneuploidy OR.Maternal age 35 years or older at delivery OR.Nucleic acid sequencing-based testing of maternal plasma for trisomy 21 may be considered medically necessary in women with high-risk singleton or high-risk twin pregnancies undergoing screening for trisomy 21 and are at a minimum of 10 weeks gestation and who meet at least ONE of the following criteria: Policy Grade: A POLICY: Effective for dates of service Januand after: Biophysical Profile (BPP) as indicated.ARCHIVED – Refer to AIM Genetic Testing Guidelines Effective 1/1/22.Group B Strep (GBS) vaginal culture for multiple gestations, or h/o preterm labor/preterm delivery.Biophysical Profile (BPP) if directed by MD.Growth scan for multiples gestations every four weeks.Fetal Fibronectin (FFN) until 32weeks, as directed by MD.Fetal echocardiogram as directed by MD.If you require fetal fibronectin (FFN) please check with your insurance carrier to confirm coverage.Cervical length until 32wks, as directed by MD.First Trimester Screening (Nuchal Translucency Ultrasound).Urine will be collected at each prenatal visit.Routine OB Labs/Pap/Urine culture/Urinalysis/Ultrasound.In those instances, payment is required in advance. We may need to send tests to specialty laboratories located in Chicago/ Texas/ Wisconsin/ California/ Utah. However, when it is not possible to use contracted labs, patients are directly responsible for those charges. Whenever possible, we will attempt to have your lab work done at facilities that have contracts with your insurance carrier.
We use Mount Sinai, Quest, DCL, Labcorp, Genzyme, NTD and BioReference. It is a good idea to know which labs your insurance company has a contract with. There can be separate charges for laboratory studies, which include pap smears, cultures, blood work, amniocentesis, CVS, and Sequential Screening for Down Syndrome. It is the patient’s responsibility to understand what may or may not be covered. Please check with your insurance company regarding your coverage for pregnancy. If you do not receive an admissions packet by 28 weeks, please notify the front desk. You will need to fill out the pre-registration form for Mount Sinai West. To help make things go smoothly during your pregnancy, here is a checklist of things to keep in mind:
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