Elevated PSA ICD-10-CM Codes

Discover the ICD-10-CM codes related to elevated PSA levels, vital for precise medical documentation, insurance billing, & targeted diagnostic procedures.

By Patricia Buenaventura on Apr 27, 2025.

Fact Checked by Karina Jimenea.

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Elevated PSA ICD-10-CM Codes

What ICD-10 codes are used for elevated PSA?

Prostate-specific antigen (PSA) is a protein produced by the prostate gland. Elevated levels can be a sign of prostate cancer, but can also indicate other prostate-related conditions. Correct coding of elevated PSA is essential for patient care, further testing, and insurance reimbursement. The ICD-10-CM system provides specific codes for elevated PSA.

The most commonly used ICD-10-CM code for elevated PSA is R97.20: Elevated prostate-specific antigen [PSA].

This is a general code for increased PSA levels, irrespective of the cause. Furthermore, it's only applicable to male adult patients aged 15-124.

(Note: While there are other ICD-10-CM codes related to prostate disorders, R97.20 is the primary code specifically for elevated PSA levels. However, it may not be used as a code for admission to a hospital as a principal diagnosis. Depending on the clinical context and findings, additional codes may be used to further specify the patient's condition.)

Which elevated PSA ICD codes are billable?

Yes, the ICD 10 code R97.20: Elevated prostate-specific antigen [PSA] is billable.

Clinical information

  • PSA is a protein produced by normal and malignant prostate gland cells.
  • Elevated PSA levels can indicate abnormal tumor markers, malignant neoplasm (prostate cancer), prostatitis, or an enlarged prostate. Rising PSA following treatment for cancer may also be possible and indicate that the cancer cells are still present.
  • Other factors like age, race, and specific procedures can influence PSA levels.
  • Regular PSA testing is often recommended for men over 50 or those with a family history of prostate cancer.
  • If an elevated PSA level is detected, further diagnostic procedures like a prostate biopsy may be necessary to determine the cause.
  • It's crucial to interpret PSA results in the context of the patient's overall health and other clinical findings.

Synonyms include

  • High PSA
  • Rising PSA
  • Raised PSA levels
  • Abnormal PSA reading
  • Increased prostate antigen levels
  • Prostate-specific antigen elevation

Frequently asked questions

When should an elevated PSA ICD code be used?

An elevated PSA ICD code should be employed when documenting a patient's medical record where the PSA levels are higher than the standard reference range, indicating a potential prostate-related concern.

What are the expected next steps after diagnosing with an elevated PSA ICD code?

Expected next steps after diagnosing elevated PSA may include further testing, such as digital rectal examination (DRE), repeat PSA tests, or a prostate biopsy to ascertain the cause of the elevation.

What does a diagnosis code for elevated PSA indicate?

A diagnosis code for elevated PSA suggests that a patient's PSA levels are above the typical range, which can indicate prostate cancer or other prostate-related conditions.

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