Prostatic Antigen Testing

• For patients age 50 and older, Medicare will pay for one (1) PSA screening test every twelve months.  Accordingly, all orders for PSA and Free PSA must be identified as either:
  • Screening("healthy patient, no symptoms")
    • The appropriate order code to be used for a "Prostatic Antigen (PSA), Screen" alone is PSA. 
    • The appropriate order code to be used for a "Prostatic Antigen (PSA), Screen" with reflex order to Free PSA Analysis  is PSAR
  • Monitoring("follow-up on patient with prostate cancer or an abnormal digital rectal exam or PSA in the past").
    • The appropriate order code to be used for a "Prostatic Antigen (PSA), Monitoring" alone is PSAM. 
    • The appropriate order code to be used for a "Prostatic Antigen (PSA), Monitoring" with reflex order to Free PSA Analysis is PSAMR. 
• An appropriate ICD-9 or diagnostic narrative and a signed ABN is required for screening PSA’s on patients under 50 years of age or when ordering more than one screening PSA on a patient in any twelve month period. 
• Any questions about this PSA screening test policy can be directed to the Laboratory Customer Service @ (607)547-3700.