Pathology/Lab Coding Alert

You'll find a one-to-one relationship for both screening and diagnostic PSA diagnoses.

When your lab performs a prostate specific antigen (PSA) test, you currently report either screening PSA using diagnosis code V76.44 (Special screening for malignant neoplasms; prostate) or diagnostic PSA code 790.93 (Elevated prostate specific antigen [PSA]).

When ICD-9 becomes ICD-10 in 2013, you'll still have one screening diagnosis code and one elevated PSA diagnosis code.

ICD-10 difference: When the physician orders a screening PSA test for a patient with no signs or symptoms of disease, you should use diagnosis code V76.44 as the reason for the test under ICD-9. With ICD-10, you'll report Z12.5 (Special screening for malignant neoplasms; prostate). For a diagnostic PSA test when the lab result shows an elevated PSA, you should report 790.93 as the ICD-9 diagnosis. When ICD-10 comes around, you'll use R97.2 (Elevated prostate specific antigen [PSA]).

Physician documentation: Currently, the physician should pinpoint whether the PSA test is a screening or diagnostic test. This won't change in 2013.

Coder tips: You'll scrap the V76.44 and 790.93 options and turn to Z12.5 and R97.2 in your ICD-10 manual. Except for the change in code number and letters, you should treat these claims the same as before.