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Urology Coding Alert

Prostate Procedures:

G0103 vs. 84153: Follow 3 Guidelines for Foolproof PSA Test Coding

Published on Tue Mar 15, 2011

The diagnosis code you choose will make or break your claim. When your urologist performs a prostate specific antigen (PSA) test, your coding isn't as simple as just assigning one code. First, you need to determine the type of test your physician performed and then 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 urologist performs a PSA test, your code choice will depend on the PSA test's purpose. 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 manager at Capital Urological Associates in Raleigh, N.C. Some other [...]
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