Alpha-fetoprotein

Alpha-fetoprotein (AFP) testing is covered for diagnosing hepatocellular carcinoma in patients at high risk (e.g., alcoholic cirrhosis, viral cirrhosis, hemochromatosis, alpha-1 antitrypsin deficiency), for differentiating benign hepatic lesions or metastases from hepatocellular carcinoma, as a marker for germ cell tumors of the testis, ovary, retroperitoneum, and mediastinum, and for monitoring response to therapy in certain malignancies. Refer to the quarterly Covered Code Lists for billing codes; the policy text does not specify frequency limits or additional documentation requirements.

"Alpha-fetoprotein (AFP) testing is covered for diagnosis of hepatocellular carcinoma in high-risk patients."

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