CPT^® 84153, Under Chemistry Procedures

The Current Procedural Terminology (CPT^®) code 84153 as maintained by American Medical Association, is a medical procedural code under the range - Chemistry Procedures.

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Summary

The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and clinicians may use PSA levels to screen for prostate cancer and follow disease progression.

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Question: Screening Labs

Hi Rhonda? This screening depends on what lab test is being done and reason from provider. . DX Z00 is more of physical. I'd be detailed if I were you 2. Let me give you some examples but it depends o... [ Read More ]

BCBS, Screening PSA (G0103) denials

[QUOTE="TThivierge, post: 505360, member: 216725"] Hi There, I do a lot of lab coding. The PSA lab test needs to linked first with a definitive dx code such as N42.9, Disorders of the Prostate, or d... [ Read More ]

ICD-10 for pathology cases that fail to yield a definitive diagnosis

Hi All I bill lab and x-ray ALL the time plus past job experience. Lab companies really hate unspecified dx codes but they do accept them. Also only use Z dx codes if they are considered FIRST listed ... [ Read More ]

BCBS, Screening PSA (G0103) denials

[QUOTE="cworrells, post: 505305, member: 650640"] Question...Is anyone else having issues with BCBS denying PSA screenings with the following codes, G0103/Z12.5? As far as all of my research goes, bot... [ Read More ]

Physician Office CLIA Lab Billing Questions

Our office is setting up a physician office CLIA lab and I had several questions about billing for this that I'm hoping that someone can shed some light on. The lab will have a single lab technician ... [ Read More ]

Denials on 84153 when w/36415

[QUOTE="karamac, post: 471026, member: 299831"] Some payers bundle the 36415 as part of the laboratory procedure, Moda is one off the top of my head. If you put the 59 modifier, and there is a policy... [ Read More ]

Physician orders for laboratory tests

So let's just talk about what an order is... whether electronic or paper.. per CLIA your laboratory needs to be able to provided documentation (i.e. a printed e-req, or paper req) that supports the te... [ Read More ]

Billing modifier 59 on 36415

No worries. I'm in a hem/onc office too and we used to do our own lab billing (outsourced now, thank goodness!) There is no CCI relationship between 84153 and 36415 so I would only use the 59 modifi... [ Read More ]

Denials on 84153 when w/36415

Is anyone having difficulty on billing 36415 and 84153 together? Lately, I have been getting a denial for 84153 from Blue Shield when billed with 36415. Health plan states to use modifier 59 on this, ... [ Read More ]

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