UHC Cell-Free Fetal DNA Testing – Commercial policy 2022T0560Z update

Effective 10/1/2022

Documentation Requirements

Updated list of CPT codes with associated documentation requirements; 0327U

Applicable Codes Updated list of ICD-10 diagnosis codes to reflect annual edits:

o Added O35.00X0, O35.01X0, O35.02X0, O35.03X0, O35.04X0, O35.05X0, O35.06X0, O35.07X0, O35.08X0, O35.09X0, O35.10X0, O35.11X0, O35.12X0, O35.13X0, O35.14X0, O35.15X0, O35.19X0, O35.AXX0, O35.BXX0, O35.CXX0, O35.DXX0, O35.EXX0, O35.FXX0, O35.GXX0, and O35.HXX0

o Removed O35.0XX0 and O35.1XX0