CodeMap®  150 North Wacker Drive
Suite 1870
Chicago, IL 60606
847-381-5465 Phone
847-381-4606 Fax
customerservice@codemap.com
      


User Information

Create New Account

Lost Password

Username:
Password:


Quick Links

PLA Codes

Laboratory Fee Schedule

2019
2018

Physician Fee Schedule

2019
2018

OPPS Fee Schedule

2019
2018

ASC Fee Schedule

2019
2018

APC Codes

2019
2018

DRG Codes

2019
2018

ASP Drug Pricing Files

January 2019
October 2018


CMS Transmittals



National Coverage Determination
Procedure Code: 84702
Human Chorionic Gonadotropin
CMS Policy Number: 190.27
Back to NCD List

Description: Human Chorionic Gonadotropin (hCG) is useful for monitoring and diagnosis of germ cell neoplasms of the ovary, testis, mediastinum, retroperitoneum, and central nervous system. In addition, hCG is useful for monitoring pregnant patients with vaginal bleeding, hypertension and/or suspected fetal loss.

Limitations:
It is not reasonable and necessary to perform hCG testing more than once per month for diagnostic purposes. It may be performed as needed for monitoring of patient progress and treatment. Qualitative hCG assays are not appropriate for medically managing patients with known or suspected germ cell neoplasms.

Frequency Limitations: It is not reasonable and necessary to perform hCG testing more than once per month for diagnostic purposes. It may be performed as needed for monitoring of patient progress and treatment. Qualitative hCG assays are not appropriate for medically managing patients with known or suspected germ cell neoplasms.



To review all requirements of this policy, please see: CMS NCD listing by Chapter

Covered ICD-10 Codes.

ICD-10Descriptor
C38.1 Malignant neoplasm of anterior mediastinum
C38.2 Malignant neoplasm of posterior mediastinum
C38.3 Malignant neoplasm of mediastinum, part unspecified
C38.8 Malig neoplm of ovrlp sites of heart, mediastinum and pleura
C45.1 Mesothelioma of peritoneum
C48.0 Malignant neoplasm of retroperitoneum
C48.1 Malignant neoplasm of specified parts of peritoneum
C48.8 Malig neoplasm of ovrlp sites of retroperiton and peritoneum
C56.1 Malignant neoplasm of right ovary
C56.2 Malignant neoplasm of left ovary
C56.9 Malignant neoplasm of unspecified ovary
C57.4 Malignant neoplasm of uterine adnexa, unspecified
C58 Malignant neoplasm of placenta
C62.00 Malignant neoplasm of unspecified undescended testis
C62.01 Malignant neoplasm of undescended right testis
C62.02 Malignant neoplasm of undescended left testis
C62.10 Malignant neoplasm of unspecified descended testis
C62.11 Malignant neoplasm of descended right testis
C62.12 Malignant neoplasm of descended left testis
C62.90 Malig neoplasm of unsp testis, unsp descended or undescended
C62.91 Malig neoplm of right testis, unsp descended or undescended
C62.92 Malig neoplasm of left testis, unsp descended or undescended
C75.3 Malignant neoplasm of pineal gland
C78.1 Secondary malignant neoplasm of mediastinum
C78.6 Secondary malignant neoplasm of retroperiton and peritoneum
C79.60 Secondary malignant neoplasm of unspecified ovary
C79.61 Secondary malignant neoplasm of right ovary
C79.62 Secondary malignant neoplasm of left ovary
C79.82 Secondary malignant neoplasm of genital organs
D39.2 Neoplasm of uncertain behavior of placenta
D49.59 Neoplasm of unspecified behavior of other GU organ
G89.3 Neoplasm related pain (acute) (chronic)
J98.59 Other diseases of mediastinum, not elsewhere classified
N89.8 Other specified noninflammatory disorders of vagina
N94.89 Oth cond assoc w female genital organs and menstrual cycle
O00.00 Abdominal pregnancy without intrauterine pregnancy
O00.01 Abdominal pregnancy with intrauterine pregnancy
O00.101 Right tubal pregnancy without intrauterine pregnancy
O00.102 Left tubal pregnancy without intrauterine pregnancy
O00.109 Unspecified tubal pregnancy without intrauterine pregnancy
O00.111 Right tubal pregnancy with intrauterine pregnancy
O00.112 Left tubal pregnancy with intrauterine pregnancy
O00.119 Unspecified tubal pregnancy with intrauterine pregnancy
O00.201 Right ovarian pregnancy without intrauterine pregnancy
O00.202 Left ovarian pregnancy without intrauterine pregnancy
O00.209 Unspecified ovarian pregnancy without intrauterine pregnancy
O00.211 Right ovarian pregnancy with intrauterine pregnancy
O00.212 Left ovarian pregnancy with intrauterine pregnancy
O00.219 Unspecified ovarian pregnancy with intrauterine pregnancy
O00.80 Other ectopic pregnancy without intrauterine pregnancy
O00.81 Other ectopic pregnancy with intrauterine pregnancy
O00.90 Unspecified ectopic pregnancy without intrauterine pregnancy
O00.91 Unspecified ectopic pregnancy with intrauterine pregnancy
O01.0 Classical hydatidiform mole
O01.1 Incomplete and partial hydatidiform mole
O01.9 Hydatidiform mole, unspecified
O02.0 Blighted ovum and nonhydatidiform mole
O02.1 Missed abortion
O02.81 Inapprop chg quantitav hCG in early pregnancy
O02.89 Other abnormal products of conception
O02.9 Abnormal product of conception, unspecified
O03.0 Genitl trct and pelvic infection fol incmpl spon abortion
O03.37 Sepsis following incomplete spontaneous abortion
O03.5 Genitl trct and pelvic infct fol complete or unsp spon abort
O03.87 Sepsis following complete or unsp spontaneous abortion
O09.A0 Suprvsn of preg with history of molar preg, unsp trimester
O09.A1 Suprvsn of preg with history of molar preg, first trimester
O09.A2 Suprvsn of preg with history of molar preg, second trimester
O09.A3 Suprvsn of preg with history of molar preg, third trimester
O11.1 Pre-existing hypertension w pre-eclampsia, first trimester
O11.2 Pre-existing hypertension w pre-eclampsia, second trimester
O11.3 Pre-existing hypertension w pre-eclampsia, third trimester
O11.4 Pre-existing htn with pre-eclampsia, comp childbirth
O11.5 Pre-existing htn with pre-eclampsia, comp the puerperium
O11.9 Pre-existing hypertension with pre-eclampsia, unsp trimester
O12.04 Gestational edema, complicating childbirth
O12.05 Gestational edema, complicating the puerperium
O12.14 Gestational proteinuria, complicating childbirth
O12.15 Gestational proteinuria, complicating the puerperium
O12.24 Gestational edema with proteinuria, complicating childbirth
O12.25 Gestational edema with proteinuria, comp the puerperium
O13.1 Gestational htn w/o significant proteinuria, first trimester
O13.2 Gestatnl htn w/o significant proteinuria, second trimester
O13.3 Gestational htn w/o significant proteinuria, third trimester
O13.4 Gestatnl htn without significant protein, comp childbirth
O13.5 Gestatnl htn without significant protein, comp the puerp
O13.9 Gestational htn w/o significant proteinuria, unsp trimester
O14.00 Mild to moderate pre-eclampsia, unspecified trimester
O14.02 Mild to moderate pre-eclampsia, second trimester
O14.03 Mild to moderate pre-eclampsia, third trimester
O14.04 Mild to moderate pre-eclampsia, complicating childbirth
O14.05 Mild to moderate pre-eclampsia, complicating the puerperium
O14.10 Severe pre-eclampsia, unspecified trimester
O14.12 Severe pre-eclampsia, second trimester
O14.13 Severe pre-eclampsia, third trimester
O14.14 Severe pre-eclampsia complicating childbirth
O14.15 Severe pre-eclampsia, complicating the puerperium
O14.20 HELLP syndrome (HELLP), unspecified trimester
O14.22 HELLP syndrome (HELLP), second trimester
O14.23 HELLP syndrome (HELLP), third trimester
O14.24 HELLP syndrome, complicating childbirth
O14.25 HELLP syndrome, complicating the puerperium
O14.90 Unspecified pre-eclampsia, unspecified trimester
O14.92 Unspecified pre-eclampsia, second trimester
O14.93 Unspecified pre-eclampsia, third trimester
O14.94 Unspecified pre-eclampsia, complicating childbirth
O14.95 Unspecified pre-eclampsia, complicating the puerperium
O15.00 Eclampsia complicating pregnancy, unspecified trimester
O15.02 Eclampsia complicating pregnancy, second trimester
O15.03 Eclampsia complicating pregnancy, third trimester
O15.1 Eclampsia complicating labor
O15.2 Eclampsia complicating the puerperium
O15.9 Eclampsia, unspecified as to time period
O16.1 Unspecified maternal hypertension, first trimester
O16.2 Unspecified maternal hypertension, second trimester
O16.3 Unspecified maternal hypertension, third trimester
O16.4 Unspecified maternal hypertension, complicating childbirth
O16.5 Unspecified maternal hypertension, comp the puerperium
O16.9 Unspecified maternal hypertension, unspecified trimester
O20.0 Threatened abortion
O24.415 Gestatnl diabetes in preg, ctrl by oral hypoglycemic drugs
O24.425 Gestatnl diab in chldbrth, ctrl by oral hypoglycemic drugs
O24.435 Gestatnl diabetes in puerp, ctrl by oral hypoglycemic drugs
O44.20 Partial placenta previa NOS or without hemor, unsp trimester
O44.21 Partial placenta previa NOS or without hemor, first tri
O44.22 Partial placenta previa NOS or without hemor, second tri
O44.23 Partial placenta previa NOS or without hemor, third tri
O44.30 Partial placenta previa with hemorrhage, unsp trimester
O44.31 Partial placenta previa with hemorrhage, first trimester
O44.32 Partial placenta previa with hemorrhage, second trimester
O44.33 Partial placenta previa with hemorrhage, third trimester
O44.40 Low lying placenta NOS or without hemorrhage, unsp trimester
O44.41 Low lying placenta NOS or without hemor, first trimester
O44.42 Low lying placenta NOS or without hemor, second trimester
O44.43 Low lying placenta NOS or without hemor, third trimester
O44.50 Low lying placenta with hemorrhage, unspecified trimester
O44.51 Low lying placenta with hemorrhage, first trimester
O44.52 Low lying placenta with hemorrhage, second trimester
O44.53 Low lying placenta with hemorrhage, third trimester
Q53.13 Unilateral high scrotal testis
Q53.23 Bilateral high scrotal testes
R10.2 Pelvic and perineal pain
R39.83 Unilateral non-palpable testicle
R39.84 Bilateral non-palpable testicles
R93.49 Abn radlgc findings on dx imaging of other urinary organs
R97.8 Other abnormal tumor markers
Z31.7 Enctr for pro mgmt and counseling for gestational carrier
Z34.00 Encntr for suprvsn of normal first pregnancy, unsp trimester
Z34.01 Encntr for suprvsn of normal first preg, first trimester
Z34.02 Encntr for suprvsn of normal first preg, second trimester
Z34.03 Encntr for suprvsn of normal first preg, third trimester
Z34.80 Encounter for suprvsn of normal pregnancy, unsp trimester
Z34.81 Encounter for suprvsn of normal pregnancy, first trimester
Z34.82 Encounter for suprvsn of normal pregnancy, second trimester
Z34.83 Encounter for suprvsn of normal pregnancy, third trimester
Z34.90 Encntr for suprvsn of normal pregnancy, unsp, unsp trimester
Z34.91 Encntr for suprvsn of normal preg, unsp, first trimester
Z34.92 Encntr for suprvsn of normal preg, unsp, second trimester
Z34.93 Encntr for suprvsn of normal preg, unsp, third trimester
Z84.82 Family history of sudden infant death syndrome
Z85.068 Personal history of malignant neoplasm of small intestine
Z85.07 Personal history of malignant neoplasm of pancreas
Z85.09 Personal history of malignant neoplasm of digestive organs
Z85.238 Personal history of other malignant neoplasm of thymus
Z85.29 Prsnl history of malig neoplm of resp and intrathorac organs
Z85.43 Personal history of malignant neoplasm of ovary
Z85.47 Personal history of malignant neoplasm of testis

The content and format of the following files and/or webpages are copywritten and the property of Wheaton Partners, LLC - dba CodeMap®. All recipients of these files agree not to distribute, reproduce and/or use the information contained within, in any manner not expressly agreed upon by the user and Wheaton Partners, LLC - dba CodeMap®.

All code-pairs and Medicare coverage information are compiled directly from Center for Medicare and Medicaid Services (CMS) and Medicare Contractor coverage policies. CodeMap® has made every reasonable effort to ensure the accuracy of the information contained. However, the ultimate responsibility for correct coding and claims submission lies with the provider of services. Both CMS and Medicare contractor coverage policy information may change at any time. CodeMap® makes no representation, warranty, or guarantee that this compilation of coverage policy information is error-free or that the use of this information will result in Medicare coverage and subsequent payment of claims. Final coverage and payment of claims are subject to many factors exclusively controlled by CMS and its contractors.


CodeMap® is a Registered Trademark of Wheaton Partners, LLC.