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ICD-10-CM A52.74, Syphilis of liver and other viscera | No Prior Auth

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`A52.74`, Syphilis of liver and other viscera

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Key Coverage Criteria

Outpatient alpha-fetoprotein testing is consideredmedically necessaryfor any of the following indications:
Screening for neural tube defects in pregnant persons;or
Evaluation or management of the following conditions:Carcinoma of unknown primary site;orGerm cell tumors;orHepatocellular carcinoma (HCC): diagnosed HCC, suspected HCC, or for those at high risk for HCC;orMediastinal mass;orOvarian cancer;orPelvic mass;orRetroperitoneal mass;orTesticular cancer or suspicious testicular mass;orThymoma or thymic cancer.
Carcinoma of unknown primary site;or
Germ cell tumors;or
Hepatocellular carcinoma (HCC): diagnosed HCC, suspected HCC, or for those at high risk for HCC;or

1 Active Policy

ANTHEM-CG-LAB-26, Outpatient Alpha-Fetoprotein Testing

Related Codes

82107(1 policies)B16.0(1 policies)B17.9(1 policies)B18.0(1 policies)B18.9(1 policies)B66.1(1 policies)B66.3(1 policies)82105(1 policies)

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