Table 1 Test level prior authorization request outcomes.
Total | |
|---|---|
(n = 4,535) | |
Time (days) between prior authorization request and decision | |
Mean (SD) | 11.97 (64.79) |
Median (Q1, Q3) | 5.0 (2.0, 12.0) |
Patient age (years) at prior authorization submission | |
Mean (SD) | 6.02 (4.69) |
Median (Q1, Q3) | 4.7 (2.2, 9.0) |
Insurance type | |
Public | 2,893 (63.8%) |
Private | 1,642 (36.2%) |
Prior authorization outcome | |
Approve | 3,235 (71.3%) |
Deny | 908 (20.0%) |
Prior authorization not required | 392 (8.6%) |
Genetic test type | |
Cytogenetic and moleculara | 2,224 (49.0%) |
Single-gene or multigene panel | 1,411 (31.1%) |
Exome | 773 (17.0%) |
Epigenetic | 86 (1.9%) |
Mitochondrial | 41 (0.9%) |
Diagnostic codes | |
Autism ICD-10-CM codes (F84.0) | 688 (15.2%) |
Developmental delay ICD-10-CM codes (F80.4, F82, F88, F80.9, R62.50) | 1,418 (31.3%) |
Intellectual disability ICD-10-CM codes (F79, F70–78, F81.9) | 323 (7.1%) |
Seizures or epilepsy ICD-10-CM codes (G40–40.919) | 121 (2.7%) |
Multiple congenital anomalies ICD-10-CM codes (Q89.7) | 136 (3.0%) |
