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20/01/2021

Tumor Markers

For Members:

  • What are Tumor Markers?

Tumor Markers is a laboratory test to check substances, often proteins that are produced by the cancer tissue itself or sometimes by the body in response to cancer growth. These substances can be detected in body samples such as blood, urine, and tissue, which helps in detecting and diagnosing some types of cancer, predict and monitor a person’s response to certain treatments, and detect recurrence.

  • What are the Limitations of Tumor Markers?
    • Few tumor markers are specific for a particular type of cancer.
    • Not every cancer has a tumor marker that has been identified to be specifically associated with it.
    • Not every person with a particular type of cancer will have an elevated level of the corresponding tumor marker.
    • Many tumor markers may also be elevated in persons with conditions or diseases other than cancer (e.g., Alpha-feto protein which is high for liver cancer but can also be elevated during pregnancy).
    • Tumor markers alone are not diagnostic for cancer; for some types of cancer, they provide additional information that can be considered in combination with your medical history and physical exam performed by your treating physician, in addition to other laboratory and/or imaging tests.
  • What are the common risks/complications?

There are no complications for Tumor Marker test.

For Healthcare Providers:

 

Recommendations:

  • All Tumor Marker requests require pre-approval from Nextcare.
  • Always submit the past medical history of the patient with details of past and current medical and surgical management provided.
Tumor Marker CPT Indications Details
Alpha-fetoprotein (AFP) 82105 Hepatocellular carcinoma and testicular germ cell tumor. To diagnose liver cancer and follow response to treatment; to assess stage, prognosis, and response to treatment of testicular tumor.
Anaplastic Lymphoma Kinase (ALK gene) 88342 Lung cancer To determine treatment and prognosis.
Cytokeratin fragment 88342 Lung cancer To help in monitoring for recurrence.
Beta-2-microglobulin (B2M) 82232 Multiple myeloma, chronic lymphocytic leukemia, and small lymphoma To determine prognosis and follow response to treatment.
Beta-human chorionic gonadotropin (BetahCG) 84702 Choriocarcinoma and testicular germ cell tumor To assess stage, prognosis, response to treatment
BCR-ABL fusion gene (Philadelphia chromosome) If P190 transcript expression was previously documented, only P190 BCR-ABL1 will be performed (CPT code(s): 81207).
If P210 transcript expression was previously documented, only P210 BCR-ABL1 will be performed (CPT code(s): 81206).
If no prior positive is documented, P190 BCR-ABL1 and P210 BCR-ABL1 will be performed (CPT code(s): 81206, 81207		 Chronic Myeloid Leukemia, Acute Lymphoblastic leukemia, Acute Myelogenous leukemia To confirm diagnosis, predict response to targeted therapy, monitor disease.
Bladder Tumor Ag (BTA) 88120 or 88121- depending on method performed Bladder cancer, cancer of kidneys and ureters. Follow up treatment for bladder cancer or, monitoring for eradication of bladder cancer or, recurrences after eradication.
CA-15-3 / CA27.29 86300 Breast Cancer For screening (only if clinically indicated), treatment effectiveness or recurrence.
Estrogen receptor/progesterone receptor 88360 Breast Cancer To determine whether treatment with hormone therapy and some targeted therapies is appropriate.
CA-125 86304 Ovarian cancer To help diagnose, response to treatment, recurrence.
Human Epididymis Protein 4 (HE4) 86305 Ovarian cancer To plan cancer treatment, assess disease progression, and monitor for recurrence but not for screening.
Carcinoembryonic antigen (CEA) 82378 Colorectal cancer For treatment effectiveness or recurrence.
Chromogranin A (CgA) 86316 Neuroendocrine tumor To help in diagnosis, assessment of treatment response, and evaluation of recurrence

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