ICD Code R97.2

ICD code R97.2 is used to indicate an elevated level of prostate-specific antigen (PSA) in the blood. This code is typically utilized in medical records and billing to document that a patient's PSA levels are higher than normal, which may warrant further investigation for conditions such as prostate cancer or other prostate-related disorders.

When using the ICD code for elevated prostate specific antigen (PSA), consider the following diagnostic criteria and symptoms:

1. Screening for Prostate Cancer: Use the code when conducting routine screening for prostate cancer in asymptomatic men, particularly those over the age of 50 or with a family history of prostate cancer.

2. Monitoring Known Prostate Conditions: Apply the code when monitoring patients with a history of prostate cancer or benign prostatic hyperplasia (BPH) to assess changes in PSA levels over time.

3. Evaluation of Symptoms: Use the code when evaluating patients presenting with symptoms such as difficulty urinating, frequent urination, especially at night, or a weak urine stream, which may warrant further investigation of PSA levels.

4. Post-Treatment Surveillance: Utilize the code for patients who have undergone treatment for prostate cancer, such as surgery or radiation, to monitor PSA levels for potential recurrence.

5. Assessment of Risk Factors: Consider the code when assessing patients with risk factors for prostate cancer, including African American ethnicity or a diet high in red meat and high-fat dairy products.

6. Follow-Up on Abnormal Digital Rectal Exam (DRE): Use the code when a patient has an abnormal DRE, which may prompt further investigation through PSA testing.

7. Investigation of Metastatic Symptoms: Apply the code when investigating symptoms that may suggest metastatic prostate cancer, such as bone pain or unexplained weight loss, and PSA testing is part of the diagnostic workup.

By adhering to these criteria, healthcare providers can ensure appropriate use of the ICD code for elevated PSA levels in clinical practice.

For the ICD code R97.2, which pertains to elevated prostate specific antigen [PSA], the relevant CPT codes that may be applicable include:

1. CPT 84153 - Prostate specific antigen (PSA); total.
2. CPT 84154 - Prostate specific antigen (PSA); free.
3. CPT 76872 - Transrectal ultrasound of the prostate.
4. CPT 55700 - Biopsy, prostate; needle or punch, single or multiple, any approach.
5. CPT 55706 - Biopsy, prostate, using an image-guided approach.

These CPT codes are commonly used in conjunction with the ICD code R97.2 for diagnostic and procedural purposes related to elevated PSA levels. It is important for healthcare providers to select the appropriate CPT code based on the specific services rendered.

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