eStar Updates and Changes: PSA lab orderable change

PSA lab orderable change

Beginning Sept. 1, PSA lab orderables will align with Medicare billing. Users will need to modify existing PSA orderables to include the word diagnostic: PSA Diagnostic [LAB116] or PSA Diagnostic Total w/ Rfx to Free PSA [LAB4157] and add two new orderables for screening: PSA Screening [LAB 6271] or PSA Screening Total w/Rfx to Free PSA [LAB6272].

Screening PSA tests are defined as those performed in the absence of signs or symptoms of prostate cancer. Screening PSA tests include PSA Screening [LAB 6271] or PSA Screening Total w/Rfx to Free PSA [LAB6272]. Medicare coverage for screening PSAs is allowable only once in a 12-month period and is intended to be used only for annual or less frequent screening in people without symptoms, without history of prostate cancer, and without ongoing concern for prostate cancer due to history of elevated PSA, abnormal digital rectal exam, or other issues. Patient may be asked to sign an ABN if test is performed at another laboratory within last 12 months

Diagnostic PSA tests are defined as those performed when patient has signs or symptoms of prostate cancer. Diagnostic PSA test include PSA Diagnostic [LAB116] or PSA Diagnostic Total w/ Rfx to Free PSA [LAB4157]. Diagnostic PSA is intended for follow up of previously diagnosed prostate cancer (whether on surveillance or previous treatment), symptoms suggestive of prostate cancer, and follow up of previously elevated screening PSA or abnormal digital rectal exam. It can be used more than once a year if necessary.

Please update your preference lists for PSA orderable(s), and use patient criteria to guide appropriate test ordering (screening versus diagnostic).