TUMOR MARKERS
See CPT codes below for individual markers
Alpha-fetoprotein (procedure code 82105)
- 070.22-070.23 Chronic viral Hepatitis B with hepatic coma without Hepatitis Delta
- 070.32-070.33 Chronic viral Hepatitis B without hepatic coma without Hepatitis Delta
- 070.44 Chronic Hepatitis C with hepatic coma
- 070.54 Chronic Hepatitis C without hepatic coma
- 095.3 Syphilis of liver
- 121.1 Clonorchiasis
- 121.3 Fascioliasis
- 155.0-155.2 Malignant neoplasm of liver, primary
- 164.2-164.9 Malignant neoplasm of anterior mediastinum
- 183.0 Malignant neoplasm of ovary
- 186.0 Malignant neoplasm of undescended testis
- 186.9 Malignant neoplasm of other and unspecified testis
- 197.1 Secondary malignant neoplasm of mediastinum
- 197.7 Malignant neoplasm of liver, secondary
- 198.6 Secondary malignant neoplasm of ovary
- 198.82 Secondary malignant neoplasm of genital organs
- 211.5 Benign neoplasm of liver and biliary passages
- 235.3 Neoplasm of uncertain behavior of liver and biliary passages
- 272.2 Mixed hyperlipidemia
- 273.4 Alpha-1 antitrypsin deficiency
- 275.0 Disorders of iron metabolism
- 275.1 Disorders of copper metabolism
- 277.00 Cystic fibrosis without meconium ileus
- 277.03 Cystic fibrosis with gastrointestinal manifestations
- 277.6 Other deficiencies of circulating enzymes
- 285.0 Sideroblastic anemia
- 571.2 Alcoholic cirrhosis of liver
- 571.40 Chronic hepatitis unspecified
- 571.41 Chronic persistent hepatitis
- 571.49 Other chronic hepatitis
- 571.5 Cirrhosis of liver without alcohol
- 608.89 Other specified disorders of male genital organs
- 793.1 Nonspecific abnormal findings on radiological and other examination of lung field
- 793.2 Nonspecific abnormal findings on radiological and other examination of other intrathoracic organs
- 793.3 Nonspecific abnormal findings on radiological and other examination of biliary tract
- 793.6 Nonspecific abnormal findings on radiological and other examination of abdominal area including retroperitoneum
- V10.07 Personal history of malignant neoplasm of liver
- V10.43 Personal history of malignant neoplasm of ovary
- V10.47 Personal history of malignant neoplasm of testis
Human Chorionic Gonadotropin (HCG) (procedure code 84703) Qualitative
- 181 Malignant neoplasm of placenta
- 183.0 Malignant neoplasm of ovary
- 186.0 Malignant neoplasm of undescended testis
- 186.9 Malignant neoplasm of other and unspecified testis
- 198.6 Secondary malignant neoplasm of ovary
- 198.82 Secondary malignant neoplasm of genital organs
- V10.43 Personal history of malignant neoplasm of ovary
- V10.47 Personal history of malignant neoplasm of testis
Human Chorionic Gonadotropin (HCG) (procedure code 84702) Quantitative
- 158.0 Malignant neoplasm of retroperitoneum
- 158.8 Malignant neoplasm of specified parts of peritoneum
- 164.2 Malignant neoplasm of anterior mediastinum
- 164.3 Malignant neoplasm of posterior mediastinum
- 164.8 Malignant neoplasm of other parts of mediastinum
- 164.9 Malignant neoplasm of mediastinum part unspecified
- 181 Malignant neoplasm of placenta
- 183.0 Malignant neoplasm of ovary
- 183.8 Malignant neoplasm of other specified sites of uterine adnexa
- 186.0 Malignant neoplasm of undescended testis
- 186.9 Malignant neoplasm of other and unspecified testis
- 194.4 Malignant neoplasm of pineal gland
- 197.1 Secondary malignant neoplasm of mediastinum
- 197.6 Secondary malignant neoplasm of retroperitoneum and peritoneum
- 198.6 Secondary malignant neoplasm of ovary
- 198.82 Secondary malignant neoplasm of genital organs
- 236.1 Neoplasm of uncertain behavior of placenta
- 623.8 Other specified noninflammatory disorders of vagina
- 625.9 Unspecified symptom associated with female genital organs
- 630 Hydatidiform mole
- 631 Other abnormal product of conception
- 632 Missed abortion
- 633.90 Unspecified ectopic pregnancy without intrauterine pregnancy
- 633.91 Unspecified ectopic pregnancy with intrauterine pregnancy
- 640.00-640.03 Threatened abortion unspecified as to episode of care
- 642.30-642.34 Transient hypertension of pregnancy unspecified as to episode of care
- 642.40-642.74 Mild or unspecified pre-eclampsia unspecified as to episode of care
- 642.90-642.94 Unspecified hypertension complicating pregnancy, childbirth, or the puerperium unspecified as to episode of care
- V10.09 Personal history of malignant neoplasm of other sites in gastrointestinal tract
- V10.29 Personal history of malignant neoplasm of other respiratory and intrathoracic organs
- V10.43 Personal history of malignant neoplasm of ovary
- V10.47 Personal history of malignant neoplasm of testis
- V22.0-V22.1 Supervision of normal first pregnancy
CA 125 (procedure code 86304)
- 180.0 Malignant neoplasm of endocervix
- 182.0 Malignant neoplasm of corpus uteri except isthmus
- 183.0 Malignant neoplasm of ovary
- 183.2 Malignant neoplasm of fallopian tube
- 183.8 Malignant neoplasm of other specified sites of uterine adnexa
- 184.8 Malignant neoplasm of other specified sites of female genital organs
- 198.6 Secondary malignant neoplasm of ovary
- 198.82 Secondary malignant neoplasm of genital organs
- 236.0-236.3 Neoplasm of uncertain behavior of uterus
- 789.39 Abdominal or pelvic swelling, mass or lump of other specified site
- V10.41-V10.44 Personal history of malignant neoplasm of ovary
CA 15-3 and CA 27.29 (procedure code 86300)
- 174.0-174.9 Malignant neoplasm of nipple and areola of female breast
- 175.0-175.9 Malignant neoplasm of nipple and areola of male breast
- 198.2 Secondary malignant neoplasm of skin
- 198.81 Secondary malignant neoplasm of breast
- V10.3 Personal history of malignant neoplasm of breast
CA 19-9 (procedure code 86301)
- 55.1 Malignant neoplasm of intrahepatic bile ducts
- 156.0 Malignant neoplasm of the gallbladder
- 156.1 Malignant neoplasm of extrahepatic bile ducts
- 156.2 Malignant neoplasm of the Ampulla of Vater
- 156.8 Malignant neoplasm of other specified sites of gallbladder and extrahepatic bile ducts
- 156.9 Malignant neoplasm of biliary tract part, unspecified site
- 157.0-157.9 Malignant neoplasm of head of pancreas
- 197.8 Secondary malignant neoplasm of other digestive organs and spleen
- 235.3 Neoplasm of uncertain behavior of liver and biliary passages
- 235.5 Neoplasm of uncertain behavior of other and unspecified digestive organs
- V10.09 Personal history of malignant neoplasm of other sites in gastrointestinal tract
Bladder Tumor Antigen (procedure code 86294)
- 188.0-188.9 Malignant neoplasm of bladder
- V10.51 Personal history of malignant neoplasm, bladder
This policy has been duplicated from the most current Medicare National Coverage Determination or Local Medical Review Policy available at the time this booklet was printed in October 2005. Medicare will consider this test(s) medically reasonable and necessary only if the test(s) was performed for any of the diagnoses/conditions listed on this page. This information is subject to change without notice, and Aurora Diagnostics Clinical Services is not responsible for consequences that may result from using such information. Aurora Diagnostics Clinical Services is not indicating one code is more acceptable than another, and that selected codes should reflect the patients actual medical condition as noted in their medical record.
