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Official Description

Human epididymis protein 4 (HE4)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Human epididymis protein 4 (HE4) is a specific type of glycoprotein that plays a significant role in the diagnosis and monitoring of certain types of ovarian cancer. This protein is particularly noted for its elevated levels in patients diagnosed with serous and endometrioid ovarian cancers, as well as some cases of clear cell ovarian cancers. The measurement of HE4 levels is crucial for screening purposes, especially in patients who exhibit symptoms that may suggest the presence of ovarian cancer or those who have a family history of the disease. The presence of elevated HE4 levels in the blood is recognized as a serologic marker, which aids healthcare professionals in identifying individuals at risk for ovarian cancer. To obtain these levels, a blood sample is collected from the patient, and analyte-specific reagents are employed to accurately detect and quantify the elevated levels of HE4 in the blood serum, providing valuable information for clinical decision-making.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Human epididymis protein 4 (HE4) testing is indicated for the following conditions:

  • Ovarian Cancer Screening - HE4 levels are measured in patients presenting with symptoms that may indicate ovarian cancer.
  • Family History of Ovarian Cancer - Patients with a family history of ovarian cancer may undergo HE4 testing as a precautionary measure.
  • Monitoring Treatment Response - HE4 can be used to monitor the effectiveness of treatment in patients diagnosed with ovarian cancer.

2. Procedure

The procedure for measuring human epididymis protein 4 (HE4) involves several key steps:

  • Blood Sample Collection - A healthcare professional collects a blood sample from the patient, typically via venipuncture. This sample is essential for the subsequent analysis of HE4 levels.
  • Serum Preparation - The collected blood sample is processed to separate the serum, which is the liquid portion of the blood that contains the analytes of interest, including HE4.
  • HE4 Level Detection - Analyte-specific reagents are utilized in the laboratory to detect and quantify the levels of HE4 in the serum. This step is critical for determining whether the HE4 levels are elevated, which may indicate the presence of ovarian cancer.

3. Post-Procedure

After the HE4 testing procedure, patients may experience minimal discomfort at the site of blood collection, but no specific post-procedure care is typically required. Results are usually communicated to the healthcare provider, who will interpret the findings in the context of the patient's overall clinical picture. If HE4 levels are found to be elevated, further diagnostic evaluations or treatment options may be discussed with the patient.

Short Descr HUMAN EPIDIDYMIS PROTEIN 4
Medium Descr HUMAN EPIDIDYMIS PROTEIN 4 (HE4)
Long Descr Human epididymis protein 4 (HE4)
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
CLIA Waived (QW) No
APC Status Indicator Conditionally packaged laboratory tests
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) T1H - Lab tests - other (non-Medicare fee schedule)
MUE 1
CCS Clinical Classification 235 - Other Laboratory
90 Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number.
GA Waiver of liability statement issued as required by payer policy, individual case
91 Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient.
GZ Item or service expected to be denied as not reasonable and necessary
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Date
Action
Notes
2011-01-01 Changed Short description changed.
2010-01-01 Added -
1992-12-31 Deleted Code deleted.
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