Anthem Blue Cross Connecticut LAB.00050 Metagenomic Sequencing for Infectious Disease in the Outpatient Setting Form

Effective Date

01/03/2024

Last Reviewed

11/09/2023

Original Document

  Reference



This document addresses metagenomic sequencing of infectious pathogens in the outpatient setting. Metagenomic testing, which employs next generation sequencing (NGS), analyzes microbial DNA from a clinical sample without reliance on traditional culture or targeted molecular tests. Clinical metagenomic testing is used for comprehensive detection of all pathogens in a single test.

This document does not address targeted or multiplex (panel-based) nucleic acid tests (NAAT) or metagenomic sequencing of infectious diseases in the inpatient setting.

Position Statement

Investigational and Not Medically Necessary:

Metagenomic sequencing for infectious diseases in the outpatient setting is considered investigational and not medically necessary for all indications.

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