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Test Code Billings Clinic: 4579 Prostate-Specific Antigen (PSA), Medicare Screening, Serum

Important Note

This test is appropriately ordered on Medicare patients when a physician/nonphysician provider (NPP) is requesting a routine screening. Medicare will pay for a screening PSA once per year for men over 50 years of age.

Specimens obtained from patients undergoing prostate manipulation, especially needle biopsy and transurethral resection, may show erroneously high results.

Prostate cancer patients under treatment with anti-androgens and LHRH agonists may exhibit markedly reduced levels of PSA.

Men treated for benign prostatic hyperplasia with inhibitors of 5α‑reductase (finasteride) may demonstrate a significant reduction in PSA levels compared to values prior to treatment.

Performing Laboratory

Billings Clinic Laboratory: Chemistry

Useful For

  • Monitoring patients with a history of prostate cancer as an early indicator of recurrence and response to treatment
  • Prostate cancer screening

Methodology

Direct Chemiluminescence

Specimen Requirements

  • Draw blood in a red-top (gel) tube(s).
  • Spin down and send 1 mL of serum frozen in plastic vial.

Storage/Stability

Specimen Type Temperature Time
Serum Refrigerated 2 days
  Frozen (preferred) 1 month
  Ambient 8 hours

 

Reject Due To

  • Specimens with greater than 1 freeze / thaw cycle
  • Specimens with apparent contamination
  • Gross hemolysis

Reference Values

0.0 - 4.0 ng/mL

Day(s) Test Set Up

Daily

Test Classification and CPT Coding

G0103

 

LCD or NCD test. ICD-10 code is required for this test. When appropriate, obtain a properly executed ABN and submit the ABN with test order(s). See “Medical Necessity and Advanced Beneficiary Notice (ABN) Policy and Form” under Resources for a copy of a form and additional information.

LOINC Code Information

Reporting Name LOINC Code
PSA 2857-1