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Sequenom Inc. Message Board

  • think_plan_act think_plan_act Oct 20, 2013 7:32 PM Flag

    UnitdHealthcare is approving MaterniT21™ PLUS, has medical billing codes too - SQMM should be atleast $15-$20

    DNA-based noninvasive prenatal tests of fetal aneuploidy (including, but not limited to,
    MaterniT21™ PLUS, verifi™ or Harmony Prenatal Test™) are "medically necessary" as
    screening tools for trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome) or trisomy 13
    (Patau syndrome) in ANY ONE of the following circumstances:

    • Maternal age of 35 years or older at delivery
    • Fetal ultrasound findings indicating an increased risk of aneuploidy
    • History of a prior pregnancy with a trisomy
    • Positive first- or second-trimester screening test results for aneuploidy
    • Parental balanced Robertsonian translocation with an increased risk of fetal trisomy 13 or
    trisomy 21.


    The codes listed in this policy are for reference purposes only. Listing of a service or device code
    in this policy does not imply that the service described by this code is a covered or non-covered
    health service. Coverage is determined by the Member’s plan of benefits or Certificate of
    Coverage. This list of codes may not be all inclusive.

    Code Description

    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
    81479 Unlisted molecular pathology procedure (effective 1/1/2013)
    81599 Unlisted multianalyte assay with algorithmic analysis (effective

    Sentiment: Strong Buy

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