Genetic Testing Codes Opened with Prior Authorization by Physician Review

Genetic testing codes require mandatory review by a Utah Medicaid physician for prior authorization. Submit documentation supporting medical necessity. Include related testing and documentation that demonstrates how the requested testing will impact the clinical management of the patient. Documentation, verifying attendance of genetic counseling by the patient’s parent(s) or legal guardian(s) with a Utah Licensed Genetic Counselor, is required.

Source: https://medicaid.utah.gov/Documents/manuals/pdfs/Medicaid Information Bulletins/Traditional Medicaid Program/2015/July2015-MIB.pdf