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Pathology/Lab Coding Alert

Clinical Lab:

G0103 vs. 84153: Can't Miss PSA Coding With These 3 Guidelines

Published on Thu May 05, 2011

Educate clients -- their diagnosis coding can make or break your claim. When your lab gets an order for a prostate specific antigen (PSA) test, you can't just assign one code based on the lab method. First, you need to determine the reason the physician ordered the test, and consider the lab method and the payer you're reporting to. Make sure you're choosing the proper codes and assigning the proper diagnoses by learning these three expert guidelines for your PSA claims. 1. Base Coding on Screening vs. Diagnostic When your lab performs a PSA assay, your code choice will depend on why the physician ordered the test. Medicare, and some other payers, require that you code screening PSA tests one way and diagnostic tests another. Screening: For a screening PSA for a Medicare beneficiary you'll report G0103 (Prostate cancer screening; prostate specific antigen test [PSA]), says Chandra L. Hines, business office [...]
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