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LCDs and LCAs
by Contractor

PLA Codes

Laboratory Fee Schedule

2024
2023

Physician Fee Schedule

2024
2023

OPPS Fee Schedule

2024-January
2023-October

ASC Fee Schedule

2024-January
2023-October

APC Codes

2024-January
2023-October

DRG Codes

2024
2023

ASP Drug Pricing Files

January 2024
October 2023


CMS Transmittals




National Coverage Determination
Procedure Code: 8XXXX
Alpha-fetoprotein
CMS Policy Number: 190.25
Back to NCD List

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.

A52.74Syphilis of liver and other viscera
B18.0Chronic viral hepatitis B with delta-agent
B18.1Chronic viral hepatitis B without delta-agent
B18.2Chronic viral hepatitis C
B66.1Clonorchiasis
B66.3Fascioliasis
C22.0Liver cell carcinoma
C22.1Intrahepatic bile duct carcinoma
C22.2Hepatoblastoma
C22.3Angiosarcoma of liver
.... and many more.


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