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December 2016 Texas Medicaid Provider Procedures Manual

Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook : 4 Noninvasive Prenatal Testing (NIPT) : 4.2 Genetic Counseling Requirement

4.2
Genetic counseling must be provided by a trained genetic counselor, nurse specialist in genetics, maternal-fetal medicine specialist, or other medical provider (e.g. obstetrician) possessing expertise in genetic counseling who is not affiliated with the genetic testing laboratory. Both pre- and post-test counseling must provide the depth of content and time for the client to make an informed testing decision.
The client must be provided with information about the purpose and nature of the tests. Documentation in the medical record must reflect that the client has been given information on the benefits, risks, and limitations of advanced screening; as well as the nature, inheritance, and implications of genetic disorders. Documentation requirements include all of the following:
The client’s ability to understand the risks, benefits, and limitations and the client’s informed choice to proceed with NIPT as evidenced by the client’s signature on a consent form specific to the NIPT to be performed
The genetic counseling must be nondirective. The purpose of the provider’s information is not to direct the client, but to allow the client to make informed medical and personal decisions.
Clients should be informed that a negative NIPT result does not ensure an unaffected pregnancy.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.