Coverage of Conditions and Treatments (Coverage Decisions)
Whole genome sequencing (WGS) uses next-generation sequencing technology to sequence and analyze the entire genome in order to identify differences between the person’s genome and the reference genome using bioinformatics tools and algorithms. The test is used to evaluate suspected genetic disorders.
The Health Technology Clinical Committee (HTCC) reviewed the technology recently and determined that WGS is a covered benefit with conditions for the evaluation of
unexplained congenital or neurodevelopmental or neurodegenerative disorders in a phenotypically affected individual. 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 diseases.
Background Information
The HTCC reviewed WGS and made a coverage determination in 2024, which was finalized on July 26, 2024. Complete information on this HTCC determination is available here: Whole genome sequencing | Washington State Health Care Authority.
Regulatory Authority and Related Information