Notification Number: 3643
Effective date: 5/3/2018
Notification date: 2/2/2018
Topic: Oncoprotein; des-gamma-carboxy-prothrombin (DCP)
Charges for CPT code 83951, oncoprotein; des-gamma-carboxy-prothrombin (DCP), will not be reimbursed.
Humana's policy regarding tumor markers when diagnosing and monitoring cancer has been updated to indicate that DCP analysis is not a covered expense.
For more information, refer to Humana's Medical and Pharmacy Coverage Policies page and search by keyword “83951.”
Claim edits do not supersede the necessity to obtain preauthorization. Preauthorization requirements are still applicable. Modifiers should be used when appropriate to accurately represent the services rendered. The use of modifiers may impact Humana’s application of these edits. For additional information, consult professional coding resources.
*All edits previously posted on Humana.com/providers for fully insured commercial Humana members may be applied to self-funded members, when requested by the self-funded group.