Internal Medicine Coding Alert

Reader Question:

Find Out What Separates 84153 From G0103

Question: Are 84153 and G0103 interchangeable for prostate specific antigen screening labs? The internists link V76.44 to both codes.

Illinois Subscriber

Answer: You cannot interchange 84153 (Prostate specific antigen [PSA]; total) and G0103 (Prostate cancer screening; prostate specific antigen test [PSA], total). G0103 describes a screening for prostate cancer.
 
Typically, you should use this code for Medicare patients who receive a screening PSA. Medicare will cover a PSA screening annually for men age 50 and older. The test is for men who present with no symptoms. You should link G0103 to V76.44 (Special screening for malignant neoplasms; other sites; prostate). On the other hand, you should report 84153 for a diagnostic prostate exam on a Medicare patient and use a nonscreening diagnosis.

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