Urology Coding Alert

Question: Our office performed a PSA test for a patient one year after successful prostate cancer treatment. What diagnosis code should I report?

Florida Subscriber

Answer: You should not use a prostate cancer diagnosis code (185, Malignant neoplasm of prostate). Instead, report V10.46 (Personal history of malignant neoplasm; genital organs; prostate) when there is no clinical or laboratory evidence of recurrent prostatic cancer.

Good practice: Check V codes for patients whose disease process is no longer active. Mislabeling a patient as an active cancer patient could affect his ability to obtain health or life insurance or affect his treatment by other physicians for other conditions.

Note: Report the performance of the PSA test with laboratory code 84153 (Prostate specific antigen [PSA]; total). The Medicare National Coverage Determination lists ICD-9 code V10.46 as a payable code for a diagnostic PSA test (84153), so you should get paid.

-- Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook.