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Effective July 25, 2021: Removal of Prior Authorization Requirement for Cell-free Fetal DNA Testing

Date: 07/01/21

Effective July 25, 2021, Ambetter from Superior HealthPlan will no longer require prior authorization for cell-free fetal DNA testing for members. Below is the listing of Current Procedural Terminology (CPT) codes included in this change to the prior authorization requirements.

CPT Codes

Description

81420

Fetal chromosomal aneuploidy (e.g., trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18 and 21.

81507

Fetal aneuploidy (trisomy 21, 18 and 13) DNA sequence analysis of selected regions using maternal plasma, algorithm reported as a risk score for each trisomy.

To review prior authorization requirements, please visit Ambetter's Prior Authorization Requirements for Health Insurance Marketplace webpage.

For questions or additional information, contact Ambetter’s Prior Authorization department at 1-800-218-7508.