Prostate Specific Antigen (Addition of ICD-9-CM 600.00, Hypertrophy (benign) of Prostate Without Urinary Obstruction, as a covered indication)

Working for an Internal Medicine physician and doing the billing, we are constantly getting questions from patients regarding the PSA not being covered. It would be nice to be able to code the 600.00 and have the charge covered.

By allowing coverage for annual PSA testing for Benign Hypertrophy as opposed to the current five year restriction of PSA testing on benign diagnosis, you would be allowing physicians to monitor the prostate through the lab work. Hypertrophic conditions do not allow good diffentation of the prostate by digital exam and the PSA blood test would be less costly as not invasive diagnostic procedures, such as ultrasoung exams for monitoring the prostate condition for neoplastic ytpe changes.

I agree ICD-9-CM 600.00 should be a covered diagnosis for Prostate Specific Antigen. I participate each year in Prostate Cancer screenings. I have seen many patients diagnosed with prostate cancer early with Hypertrophy without urinary obstruction. Early detection is critical.

9/10 times, a patient with BPH is having a PSA screening done. Its about time we have 600.00 added to the list....

Adding BPH 600.00 would only claify the medical necessity of ruling out prostate cancer. In preventive medicine it is very important to have a base line PSA when BPH is present rather there are other urology syptoms or not. Allowing this would only increase the quality of care a patient receives.

As a family physician, it is my job to find cancer. Many a gentleman has BPH w/o obstruction, and a PSA may help us to find cancer earlier. Additionally, since prostate cancer is so common, we need to screen broadly and widely to find as many cases as we can. Having both BPH with obstruction and BPH w/o obstruction makes good clinical sense. Thank you for your consideration.

Many physicians feel using "BPH" or "Benign hypertrophy of prostate" should be enough information making the PSA a medically necessary test. They feel that if the prostate is enlarged at all - that should cover the test. It should not have to be linked with urinary conditions.

I support the addition of ICD-9-cm 600.00 as a coverd dinication for the Prostate Specific Antigen.

I beleive 600.00 should definately be added to coverage for PSA. It really makes no sense that it is allowed for 600.01 and not 600.00. Whether there is obstruction or not is not the issue. The fact that the enlargement could be several diagnosis's and all should be investigated. PSA can give immediate direction for the investigation.

This is wonderful. I support the addition of 600.00 as a covered indication for PSA

Prostate can increase in size which may or may not cause obstruction of bladder outflow. Such conditions may not correlate well with the tissue type, prostate growth and the severity of symptoms. In another way PSA measurement can provides information that may reflect prostate cellular activity associated with prostate enlargement regardless it is involvement in bladder obstruction.