ICD Code R97.2

ICD code R97.2 is elevated prostate specific antigen (PSA), indicating higher than normal levels of PSA in the blood, which may suggest prostate conditions such as inflammation, enlargement, or cancer.

1. Laboratory test results indicate a prostate specific antigen (PSA) level above the established reference range for the patient’s age.

2. No definitive diagnosis of prostate cancer or other specific prostate pathology has been established at the time of coding.

3. The elevated PSA finding is documented by the provider as clinically significant and warrants further evaluation or monitoring.

4. The patient may present with or without lower urinary tract symptoms such as increased frequency, urgency, hesitancy, or nocturia.

5. The elevated PSA is not attributable to a recent prostate procedure, infection, or other transient cause, unless specifically documented as such.

Relevant CPT codes that may be used to treat ICD code R97.2 include:

- 84153 (Prostate specific antigen [PSA]; total)

- 84154 (Prostate specific antigen [PSA]; free)

- 55700 (Biopsy, prostate; needle or punch, single or multiple, any approach)

- 76872 (Transrectal ultrasound of the prostate)

- 55706 (Biopsy, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance)

- 72195 (MRI pelvis without contrast)

- 72197 (MRI pelvis with and without contrast)

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