Coverage of Conditions and Treatments (Coverage Decisions)
Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.
List also available in PDF format.
See Treatment Guidelines and Resources for additional information.
Cell-free DNA (cfDNA) prenatal screening for chromosomal aneuploidies
cfDNA screening is a form of noninvasive prenatal testing used to determine the risk that a fetus will be born with certain genetic abnormalities. The testing analyzes fragments of fetal DNA that are present in maternal blood to detect trisomy 21 (Down syndrome), trisomy 13 (Patau syndrome), trisomy 18 (Edwards syndrome), and problems with the number of sex chromosomes such as Klinefelter syndrome and Turner syndrome.
The Health Technology Clinical Committee (HTCC) reviewed the testing recently and determined that cfDNA testing is a covered benefit. However, L&I’s Office of the Medical Director has determined that this HTCC coverage determination does not apply to Washington’s workers’ compensation, which only covers work-related injuries or occupational disease.
The HTCC reviewed cfDNA testing and made a determination in January 2020, which was finalized in May 2020. Complete information on this HTCC determination is available here: What we're working on | Washington State Health Care Authority.