Benefit Category
Diagnostic Laboratory Tests
Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.
Indications and Limitations of Coverage Indications
Human Chorionic Gonadotropin (hCG) is useful for monitoring and diagnosis of germ cell neoplasms of the ovary, testis, mediastinum, retroperitoneum, and central nervous system. In addition, hCG is useful for monitoring pregnant patients with vaginal bleeding, hypertension and/or suspected fetal loss.
Limitations
It is not reasonable and necessary to perform hCG testing more than once per month for diagnostic purposes. It may be performed as needed for monitoring of patient progress and treatment. Qualitative hCG assays are not appropriate for medically managing patients with known or suspected germ cell neoplasms.
Note: Scroll down for links to the quarterly Covered Code Lists (including narrative).
Cross Reference Also see the Medicare Claims Processing Manual, Chapter 120, Clinical Laboratory Services Based on Negotiated Rulemaking.
