Human Chorionic Gonadotropin, National Coverage ...

Human Chorionic Gonadotropin, Quantitative

National Coverage Determination

CPT Code: 84702

Code C38.1 C38.2 C38.3 C38.8 C45.1 C48.0 C48.1 C48.8 C56.1 C56.2 C56.9 C57.4 C58 C62.00 C62.01 C62.02 C62.10 C62.11 C62.12 C62.90 C62.91 C62.92 C75.3 C78.1 C78.6 C79.60 C79.61 C79.62 C79.82 D39.2 D49.59 G89.3 N89.8 N94.89 O00.9 O00.90 O00.91 O01.0 O01.1 O01.9 O02.0 O02.1 O02.81 O02.89 O02.9 O03.0 O03.37

Description Malignant neoplasm of anterior mediastinum Malignant neoplasm of posterior mediastinum Malignant neoplasm of mediastinum, part unspecified Malignant neoplasm of overlapping sites of heart, mediastinum and pleura Mesothelioma of peritoneum Malignant neoplasm of retroperitoneum Malignant neoplasm of specified parts of peritoneum Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum Malignant neoplasm of right ovary Malignant neoplasm of left ovary Malignant neoplasm of unspecified ovary Malignant neoplasm of uterine adnexa, unspecified Malignant neoplasm of placenta Malignant neoplasm of unspecified undescended testis Malignant neoplasm of undescended right testis Malignant neoplasm of undescended left testis Malignant neoplasm of unspecified descended testis Malignant neoplasm of descended right testis Malignant neoplasm of descended left testis Malignant neoplasm of unspecified testis, unspecified whether descended or undescended Malignant neoplasm of right testis, unspecified whether descended or undescended Malignant neoplasm of left testis, unspecified whether descended or undescended Malignant neoplasm of pineal gland Secondary malignant neoplasm of mediastinum Secondary malignant neoplasm of retroperitoneum and peritoneum Secondary malignant neoplasm of unspecified ovary Secondary malignant neoplasm of right ovary Secondary malignant neoplasm of left ovary Secondary malignant neoplasm of genital organs Neoplasm of uncertain behavior of placenta Neoplasm of unspecified behavior of other genitourinary organ Neoplasm related pain (acute) (chronic) Other specified noninflammatory disorders of vagina Other specified conditions associated with female genital organs and menstrual cycle Ectopic pregnancy, unspecified Unspecified ectopic pregnancy without intrauterine pregnancy Unspecified ectopic pregnancy with intrauterine pregnancy Classical hydatidiform mole Incomplete and partial hydatidiform mole Hydatidiform mole, unspecified Blighted ovum and nonhydatidiform mole Missed abortion Inappropriate change in quantitative human chorionic gonadotropin (hCG) in early pregnancy Other abnormal products of conception Abnormal product of conception, unspecified Genital tract and pelvic infection following incomplete spontaneous abortion Sepsis following incomplete spontaneous abortion

Medicare Limited Coverage Tests ? Covered Diagnosis Codes Source: National Coverage Determinations Coding Policy Manual and Change Report (ICD-10-CM) October 2017

Effective October 1, 2017

Medicare Limited Coverage Tests

Human Chorionic Gonadotropin, Quantitative

National Coverage Determination

Code O03.5 O03.87 O11.1 O11.2 O11.3 O11.9 O13.1 O13.2 O13.3 O13.9

O14.00 O14.02 O14.03 O14.10 O14.12 O14.13 O14.20 O14.22 O14.23 O14.90 O14.92 O14.93 O15.00 O15.02 O15.03 O15.1 O15.2 O15.9 O16.1 O16.2 O16.3 O16.9 O20.0 R10.2 R93.49 R97.8 Z34.00 Z34.01 Z34.02 Z34.03 Z34.80 Z34.81 Z34.82 Z34.83 Z34.90 Z34.91 Z34.92 Z34.93

Description Genital tract and pelvic infection following complete or unspecified spontaneous abortion Sepsis following complete or unspecified spontaneous abortion Pre-existing hypertension with pre-eclampsia, first trimester Pre-existing hypertension with pre-eclampsia, second trimester Pre-existing hypertension with pre-eclampsia, third trimester Pre-existing hypertension with pre-eclampsia, unspecified trimester Gestational [pregnancy-induced] hypertension without significant proteinuria, first trimester Gestational [pregnancy-induced] hypertension without significant proteinuria, second trimester Gestational [pregnancy-induced] hypertension without significant proteinuria, third trimester Gestational [pregnancy-induced] hypertension without significant proteinuria, unspecified trimester Mild to moderate pre-eclampsia, unspecified trimester Mild to moderate pre-eclampsia, second trimester Mild to moderate pre-eclampsia, third trimester Severe pre-eclampsia, unspecified trimester Severe pre-eclampsia, second trimester Severe pre-eclampsia, third trimester HELLP syndrome (HELLP), unspecified trimester HELLP syndrome (HELLP), second trimester HELLP syndrome (HELLP), third trimester Unspecified pre-eclampsia, unspecified trimester Unspecified pre-eclampsia, second trimester Unspecified pre-eclampsia, third trimester Eclampsia complicating pregnancy, unspecified trimester Eclampsia complicating pregnancy, second trimester Eclampsia complicating pregnancy, third trimester Eclampsia complicating labor Eclampsia complicating the puerperium Eclampsia, unspecified as to time period Unspecified maternal hypertension, first trimester Unspecified maternal hypertension, second trimester Unspecified maternal hypertension, third trimester Unspecified maternal hypertension, unspecified trimester Threatened abortion Pelvic and perineal pain Abnormal radiologic findings on diagnostic imaging of other urinary organs Other abnormal tumor markers Encounter for supervision of normal first pregnancy, unspecified trimester Encounter for supervision of normal first pregnancy, first trimester Encounter for supervision of normal first pregnancy, second trimester Encounter for supervision of normal first pregnancy, third trimester Encounter for supervision of other normal pregnancy, unspecified trimester Encounter for supervision of other normal pregnancy, first trimester Encounter for supervision of other normal pregnancy, second trimester Encounter for supervision of other normal pregnancy, third trimester Encounter for supervision of normal pregnancy, unspecified, unspecified trimester Encounter for supervision of normal pregnancy, unspecified, first trimester Encounter for supervision of normal pregnancy, unspecified, second trimester Encounter for supervision of normal pregnancy, unspecified, third trimester

Medicare Limited Coverage Tests ? Covered Diagnosis Codes Source: National Coverage Determinations Coding Policy Manual and Change Report (ICD-10-CM) October 2017

Effective October 1, 2017

Medicare Limited Coverage Tests

Human Chorionic Gonadotropin, Quantitative

National Coverage Determination

Code Z85.068 Z85.07 Z85.09 Z85.238 Z85.29 Z85.43 Z85.47

Description Personal history of other malignant neoplasm of small intestine Personal history of malignant neoplasm of pancreas Personal history of malignant neoplasm of other digestive organs Personal history of other malignant neoplasm of thymus Personal history of malignant neoplasm of other respiratory and intrathoracic organs Personal history of malignant neoplasm of ovary Personal history of malignant neoplasm of testis

Medicare Limited Coverage Tests ? Covered Diagnosis Codes Source: National Coverage Determinations Coding Policy Manual and Change Report (ICD-10-CM) October 2017

Effective October 1, 2017

Medicare Limited Coverage Tests

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