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National Coverage Determination
Procedure Code:
8XXXX
Alpha-fetoprotein
CMS Policy Number: 190.25
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Description: Alpha-fetoprotein (AFP) is a polysaccharide found in some carcinomas. It is effective as a biochemical marker for monitoring the response of certain malignancies to therapy.
Indications:
AFP is useful for the diagnosis of hepatocellular carcinoma in high-risk patients (such as alcoholic cirrhosis, cirrhosis of viral etiology, hemochromatosis, and alpha 1-antitrypsin deficiency) and in separating patients with benign hepatocellular neoplasms or metastases from those with hepatocellular carcinoma and, as a non-specific tumor associated antigen, serves in marking germ cell neoplasms of the testis, ovary, retro peritoneum, and mediastinum.
To review all requirements of this policy, please see:
CMS NCD listing by Chapter
Covered ICD-10 Codes.
| A52.74 | Syphilis of liver and other viscera |
| B18.0 | Chronic viral hepatitis B with delta-agent |
| B18.1 | Chronic viral hepatitis B without delta-agent |
| B18.2 | Chronic viral hepatitis C |
| B66.1 | Clonorchiasis |
| B66.3 | Fascioliasis |
| C22.0 | Liver cell carcinoma |
| C22.1 | Intrahepatic bile duct carcinoma |
| C22.2 | Hepatoblastoma |
| C22.3 | Angiosarcoma of liver |
.... and many more.
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coverage and payment of claims are subject to many factors exclusively
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