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Test Code PSA PROSTATE-SPECIFIC ANTIGEN (PSA), SCREENING, SERUM

Additional Codes

Software Test Code
Label text                            PSA                                           
EPIC LAB116

Performing Laboratory

NorDx Laboratories

Useful For

Aiding in the detection of early-stage prostate cancer in conjunction with digital rectal examination (DRE)

This test should be ordered for routine screening purposes (i.e. annual screening). If ordering for other reasons, order test PSAD.

 

The measured PSA value of a patient’s sample can vary depending on the testing procedure used. PSA values determined on patient samples from different manufacturers cannot be directly compared with one another and could be the cause of erroneous medical interpretations.  

Method Name

Electrochemiluminescent Immunoassay (ECLIA) via Roche Diagnostics instrumentation

Reference Values

Males:
≤ 4.0 ng/mL

 

Females:
Reference values have not been established.

 

LOD = 0.014 ng/mL

Days and Times Test Performed

Monday through Sunday

Report Available

1 Day

Specimen Type

Serum

Preferred Container

Serum Separator Tube (SST)

Preferred Volume

Serum: 1 mL (Serum Separator Tube (SST))

Minimum Volume

Serum: 0.5 mL (Serum Separator Tube (SST))

Specimen Collection and Handling

1. Spin specimen, separate from clot and send refrigerated.

2. PSA specimens should be drawn prior to prostatic manipulations such as DRE, prostatic massage, transrectal ultrasound (TRUS), and prostatic biopsy.

These procedures may falsely elevate PSA values.

Specimen Stability Information

Specimen Type: Serum

Frozen: 3 Months

Refrigerated: 3 Days

Must be spun/separated within: 2 Hours

Add On Capable

Yes

Advance Beneficiary Notice Requirements

This test, when ordered on Medicare patients, is subject to the National Coverage Determination (NCD) policies. Please verify that the diagnosis code (ICD code) you have chosen demonstrates medical necessity for the test as documented in the physician’s patient record. The CMS web site is available to assist you with this verification. A properly executed Advance Beneficiary Notice (ABN) must be submitted with the specimen if medical necessity is not demonstrated by the ICD code chosen.

CPT Code Information

CPT Code

CPT Description

CPT Disclaimer
84153 Prostate Specific Antigen (PSA), Total  
G0103 Prostate Cancer Screening, Prostate Specific Antigen (PSA) Test Medicare Only

Keywords

PSA (PROSTATE-SPECIFIC ANTIGEN)

Performing Laboratory Location

NorDx Laboratories

LOINC Code Information

2857-1

Acceptable Alternative Container(s)

Plasma Separator Tube (PST)

Red Top Tube

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