Chromosomal Microarray (CMA) Analysis for Prenatal Evaluation and Evaluation of Patients with Developmental Delay/ Intellectual Disability or Autism Spectrum Disorder 2.02.42
Excellus BlueCross BlueShield policy 2.02.42 covers chromosomal microarray analysis (CMA) for children with apparent nonsyndromic developmental delay or intellectual disability, autism spectrum disorder, or multiple anomalies not specific to a well-delineated genetic syndrome, and for pregnant patients undergoing invasive prenatal diagnostic testing. The 11/20/25 annual review removed the policy criteria for FMR1 gene analysis and the criterion that genetic test results have the potential to impact clinical management. The current effective date is November 20, 2025, and CMA used to confirm a disorder that is routinely diagnosed on clinical evaluation alone is considered not medically necessary.