Serum Tumor Markers for Malignancies
This reimbursement policy governs coverage and billing guidance for serum tumor markers and related laboratory biomarker tests (e.g., AFP, CA-125, CA19-9, beta-2 microglobulin, free light chains) for Blue Cross Blue Shield - Texas members; it applies to clinical indications and monitoring as described in the document.
Added billing code 0599U effective 10/01/2025.
Expanded indications for multiple tumor markers (AFP, CA-125, CA19-9, CA15-3/27.29, inhibin, LDH, beta-2 microglobulin) to include additional ovarian cancer subtypes for monitoring/follow-up and removed the "(less common)" designation from certain ovarian cancer rows.
Beta-2 microglobulin (B2M) indications expanded for chronic lymphocytic leukemia/small lymphocytic lymphoma to include prognostic and/or therapy determination.
Calcitonin indications expanded to include workup for adenocarcinoma, anaplastic/undifferentiated epithelial tumors, and occult primary cancers.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.