CG-LAB-26 Outpatient Alpha-Fetoprotein Testing

Policy ANTHEM-CG-LAB-26 addresses outpatient alpha-fetoprotein (AFP) testing. AFP testing is medically necessary for screening for neural tube defects in pregnant persons or for evaluation/management of carcinoma of unknown primary, germ cell tumors, hepatocellular carcinoma (diagnosed, suspected, or high risk), mediastinal/pelvic/retroperitoneal masses, ovarian cancer, testicular cancer or suspicious testicular mass, and thymoma/thymic cancer. It is not medically necessary for all other indications when these criteria are not met.

"Outpatient alpha-fetoprotein testing is consideredmedically necessaryfor any of the following indications:"

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