UHC – Genetic Testing for Neuromuscular Disorders – Policy 2020T0598B Update 9/1/2020

Revised and reformatted list of proven and medically necessary indications:

•  Replaced criterion for suspected congenital muscular dystrophy or myopathy requiring “evidence of diffuse muscle weakness” with “evidence of muscle weakness”
• Replaced criterion for suspected hereditary spastic paraplegia (HSP) or ataxia requiring “peripheral neuropathy and ataxia” with “peripheral neuropathy or ataxia”
• Removed criterion for suspected limb girdle muscular dystrophy (LGMD) requiring “clinical features do not suggest a specific LGMD sub-type”

Applicable Codes

• Removed CPT code 81443
• Revised description for CPT code 81479

Supporting Information

• Updated Description of Services, Clinical Evidence, CMS, and References sections to reflect the most current information
• Archived previous policy version 2019T0598A

Source: https://www.uhcprovider.com/content/dam/provider/docs/public/policies/index/commercial/genetic-testing-neuromuscular-disorders-09012020.pdf