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Concert Genetics Policy Revisions

Fecha: 08/10/25

Thank you for your continued partnership with Ambetter from Meridian. As you know, we continually review and update our payment and utilization policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members. We are writing today to inform you of the revision to existing policies the will be implemented effective 11/24/2025.

Policy Number

Policy Name

Policy Summary

CG.CP.MP.01

Infectious Disease: Respiratory Lab Testing

This policy outlines criteria for Syndromic/Multiplex Respiratory Panels with 6 or More Targets, SARS-CoV-2, RSV, or Influenza A/B, OR Multiplex Respiratory Viral Panels with 5 or Fewer Targets, Bacterial Respiratory Infection/Pneumonia Panels, Influenza A and B Antibody Tests, Group A Streptococcus Pharyngitis Tests, Group A Streptococcus Pharyngitis Cultures, and Group A Streptococcus Antibody Tests.

CG.CP.MP.02

Infectious Disease: Multi-System Lab Testing

This policy outlines the appropriate use of tests for pathogens that can cause multisystem symptoms and/or infections. Tests for pathogens that infect multiple body systems can be targeted to detect a specific pathogen(s) or non-targeted to broadly detect nucleic acid from any potential pathogen.

CG.CP.MP.03

Infectious Disease: Dermatologic Testing

This policy outlines the appropriate use of Microscopy/Peroxidase Tests, Fungal Culture, and Culture-Independent Molecular Tests (NAAT/PCR) for Onychomycosis.

CG.CP.MP.04

Infectious Disease: Gastroenterologic Lab Testing

This policy outlines appropriate use of multi-pathogen panels, as well as diagnostic assays targeted at Helicobacter pylori (H. pylori).

CG.CP.MP.05

Infectious Disease Primary Care and Preventive Lab Screening

This policy outlines criteria for human papillomavirus (HPV), hepatitis C virus (HCV), and group B streptococcus (GBS).

CG.CP.MP.06

Infectious Disease: Vector-Borne and Tropical Diseases Lab Testing

This policy outlines criteria for Lyme disease and Zika virus testing via serologic and molecular methods.

CG.CP.MP.07

Infectious Disease: Genitourinary Lab Testing

This policy outlines criteria for Targeted Vaginitis/Vaginosis Pathogen Testing, Expanded Multiplex Vaginitis/Vaginosis Pathogen Panels, Urine Culture for Asymptomatic Bacteriuria, and Molecular/Multiplex UTI Panels.

CG.CC.PP.01

Concert Laboratory Payment Policy

This policy outlines correct coding requirements for lab testing, excluding and molecular testing

For detailed information about these policies, please refer to our website at www.MIMeridian.com and or questions about this or any of our payment policies, please don’t hesitate to reach out to our Provider Services team via the Intake Form on our website.