Revision to Prostate Cancer Screening Tests and Procedures

By way of further clarification for the bulletin below, a screening PSA is to be ordered when performed on patients without the diagnosis of prostate cancer and along with tests such as the digital rectal exam. A diagnostic PSA should be ordered after the diagnosis of prostate cancer is made and the patient is being followed for therapy. Both are total serum PSA tests just used in different contexts.

The following was the original bulletin regarding Prostate Cancer Screening Tests and Procedures:

Due to recent HCFA changes, laboratory requests for Prostate Specific Antigen (PSA) testing should be written as follows:

a) PSA, Screening (abbreviated as PSAS) or
b) PSA, Total (abbreviated as PSA).

Written orders that do not specify one of these two options will no longer be accepted. These orders may be written on either of the Pathology Doctor's Order Form A-1a (MH07910 or MH08429).

In addition, screening digital rectal examinations and screening PSA blood tests must be billed using screening billing codes and a new ICD-9 code has been added for this purpose:

V76.44 Special Screening for Malignant Neoplasms, Prostate.

The Medicare coverage rule is as follows:

"Requirements for Prostate Cancer Screening Tests and Procedures: Performed on a male Medicare beneficiary of over 50 years of age (for services starting at least one day after the beneficiary attained age 50) and at a frequency no greater than every twelve months".

Contact Dr. Ronald Feld, Director, Chemistry Laboratory, 356-1759 or Rose Meyer, Section Manager, 356-0437, with any questions.