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Home/Diagnosis/ICD-10 Coding for Elevated PSA

ICD-10 Coding for Elevated PSA

R97.20
R97.21

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

Also Known as:
High PSA
Increased Prostate-Specific Antigen
Increased PSA levels
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Key Information: ICD-10 Coding for Elevated PSA

Essential facts and insights about ICD-10 Coding for Elevated 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:
  • PSA level >4 ng/mL without known cause
documentation:
  • Document specific PSA value and rule out transient causes

Important Notes

  • • Ensure documentation specifies PSA levels and excludes transient causes.

Rising PSA following treatment for malignant neoplasm of prostate

Billable Code
R97.21
Billable

Important Notes

  • • Ensure linkage to prostate cancer history is documented.
Ancillary Codes

Additional codes that may be used with this diagnosis

N40.1

Benign prostatic hyperplasia with lower urinary tract symptoms

Use alongside R97.20 if BPH is confirmed.

Frequently Asked Questions

What is the ICD-10 code for elevated PSA?

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

When should R97.21 be used?

R97.21 is used for rising PSA levels following treatment for prostate cancer, requiring documentation of cancer history.

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