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Home/Diagnosis/ICD-10 Coding for Abnormal PSA

ICD-10 Coding for Abnormal PSA

R97.20
R97.21

Complete ICD-10-CM coding and documentation guide for icd-10 coding for abnormal psa includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Elevated PSA
Abnormal PSA reading
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Key Information: ICD-10 Coding for Abnormal PSA

Essential facts and insights about ICD-10 Coding for Abnormal PSA

Use ICD-10 code R97.20 for elevated prostate specific antigen [psa], ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Elevated prostate specific antigen [PSA]

Billable Code
R97.20
Billable

Diagnostic Criteria

clinical_criteria:
  • • PSA level above age-adjusted threshold without symptoms
coding_criteria:
  • • No confirmed diagnosis of prostate cancer or BPH

Applicable To

  • • Elevated PSA without a history of prostate cancer

Important Notes

  • • Ensure PSA levels are documented with clinical context, including any medications affecting PSA.

Rising PSA following treatment for malignant neoplasm of prostate

Billable Code
R97.21
Billable

Applicable To

  • • Biochemical recurrence of prostate cancer

Important Notes

  • • Ensure documentation includes treatment history and PSA trends.
Ancillary Codes

Additional codes that may be used with this diagnosis

Z12.5

Encounter for screening for malignant neoplasm of prostate

Use for asymptomatic PSA screening.

Frequently Asked Questions

What is the ICD-10 code for abnormal PSA?

The ICD-10 code for elevated PSA is R97.20, used for elevated PSA levels without a confirmed diagnosis of prostate cancer.

When should R97.21 be used?

R97.21 is used for rising PSA levels following treatment for prostate cancer, indicating biochemical recurrence.

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