Congenital CMV screening of an infant is simple and painless. It is accomplished using either a urine or saliva sample. The inside of your baby’s cheek is swabbed when a saliva sample is taken. It is very important that this swabbing be done at least 90 minutes, ideally 120 minutes, after feeding as CMV could be present in breastmilk.
This testing is time-sensitive and the urine or saliva sample must be taken before your baby is 21 days old to be accurate for the detection of congenital CMV infection. The sample may be taken at your medical providers’ office or directly at a lab. Please contact your baby’s doctor as soon as you are told you need this testing to be done. Dried blood spots are still being studied for cCMV testing in newborns after 21 days have elapsed.
If the clinic or hospital is a client of ARUP, they can order the OraCollect OC-100 swabs from ARUP client supplies (item #49295). If they are not ARUP clients, they should contact their reference lab for kit 2 supplies or contact the kit vendor directly (DNA Genotek). If kits for PCR testing on saliva are not available, a PCR for CMV can be sent on a urine sample.
Many insurance companies, including Medicaid, report that this testing is covered. The CPT code for qualitative CMV detection by PCR (via urine or saliva) is 87496, which is considered to be the most sensitive for congenital CMV testing. CPT code 87497 represents quantitative CMV detection by PCR (via urine or saliva) and may be used by Viracor-IBT Laboratories.
cCMV can only be diagnosed by testing a newborn’s urine or saliva within the first 21 days of life. If an infant’s urine or saliva is tested later than that, it will be impossible to determine if the infection was present at birth or acquired later, since CMV is a common virus (CDC, 2020).
In Massachusetts, routine newborn screening for congenital diseases is required and occurs immediately after birth. cCMV is more common than many of the 66 conditions screened for in an infant after birth; yet, in Massachusetts, cCMV is not included during this process.
Currently in Massachusetts, there is no statewide policy on cCMV screening. In a few hospitals, infants are screened for cCMV only if they fail the newborn hearing screen. This is called targeted-screening. More than half of MA birthing hospitals have no screening program at all, based on a recent survey.
No. 87% of infants born with cCMV are asymptomatic at birth. The most common health problem that cCMV causes is progressive hearing loss. In a recent study, 43% of infants with CMV-related sensorineural hearing loss were missed with targeted screening (Fowler et. al., 2017).