CurrentUnitedHealthcarePolicy CS150KS.03

Whole Exome and Whole Genome Sequencing (Non-Oncology Conditions) (for Kansas Only)

State-specific UnitedHealthcare medical policy (Kansas) governing coverage of whole exome sequencing (WES) and whole genome sequencing (WGS) for non-oncology (constitutional/heritable) conditions, directing readers to InterQual CP: Molecular Diagnostics for detailed medical necessity criteria and listing applicable procedure codes.

Policy Summary

PayerUnitedHealthcare

PolicyWhole Exome and Whole Genome Sequencing (Non-Oncology Conditions) (for Kansas Only)

Policy CodePolicy CS150KS.03

Change TypeRevised; codes added; sections removed

Effective DateApril 1, 2026

Next Review Date

Key ActionDocument medical necessity in the patient record and use InterQual CP: Molecular Diagnostics criteria when seeking coverage/authorization.

POLICY UPDATE CHANGES

Revised coverage rationale language to indicate WES and WGS are proven and medically necessary in certain circumstances; refers to InterQual CP: Molecular Diagnostics topics (Hereditary Hearing Loss; WGS/WES/CMA for congenital or hereditary disorders).

Added procedure codes 0582U, 0583U, and 81354 to the Applicable Codes list.

Removed Definitions, Description of Services, Clinical Evidence, and References sections from the policy.

InterQual (2 topics)Primary external criteria sources

Kansas onlyGeographic scope

~30Procedure codes listed