- ICD-10 Code: R97.20
- Description: Elevated Prostate Specific Antigen (PSA)
- Indications: Used to indicate a diagnosis of elevated PSA levels, which can be a sign of prostate cancer or other prostate-related conditions.
- Reimbursement Note: R97.2 should not be used for reimbursement purposes because there are multiple codes below it that provide a greater level of detail.
- Effective Date: The 2024 edition of ICD-10-CM R97.2 became effective on October 1, 2023.
- Version Note: This is the American ICD-10-CM version of R97.2, other international versions of ICD-10 R97.2 may differ.
ICD-10-CM Diagnosis Code Section Details:
| ICD-10-CM | Description | Code History |
| R97.2 (5th Character Required) | Elevated prostate specific antigen [PSA] | Change Effective Date:10/01/2016 |
| R97.20 | Elevated prostate specific antigen [PSA] | Change Effective Date:10/01/2016 |
| R97.21 | Rising PSA following treatment for malignant neoplasm of prostate | Change Effective Date:10/01/2016 |
| R97.8 | Other abnormal tumor markers | Change Effective Date:10/01/2015 |
Convert ICD-10-CM R97.20 to ICD-9-CM:
| 2024 ICD-10-CM CMS General Equivalence Mappings (GEM) | |
|
ICD-10-CM Codes |
|
| R97.20 | Elevated prostate specific antigen [PSA] |
|
ICD-9-CM codes with description |
|
| 790.93 | Elevated prostate specific antigen [psa] |
NOTE: When converting between ICD-9-CM and ICD-10-CM codes, it’s important to consider the clinical context for the most accurate conversion.
Clinical Information:
- Elevated PSA levels could be caused by multiple factors and do not always indicate cancer; they could even indicate benign conditions like BPH or prostatitis-related inflammation.
- PSA tests are commonly utilized as screening measures to detect prostate cancer for men over 50 and those at increased risk due to family histories of cancer.
Coding Guidance:
- Electronic submissions do not need to contain decimal marks for claims to avoid rejection.
- Cancer markers fall under Chapter 18 (Symptoms and signs and abnormal laboratory and clinical findings not otherwise classified) of ICD-10-CM classification system and specifically under abnormal cancer markers.
Code History:
| Year | Code History | Comments |
| 2016 | 10/1/2015 | New code (first year of non-draft ICD-10-CM) |
| 2017 | 10/1/2016 | Deleted code |
| 2017 | 10/1/2016 | New code |
| 2018 | 10/1/2017 | No change |
| 2019 | 10/1/2018 | No change |
| 2020 | 10/1/2019 | No change |
| 2021 | 10/1/2020 | No change |
| 2022 | 10/1/2021 | No change |
| 2023 | 10/1/2022 | No change |
| 2024 | 10/1/2023 | No change |
Approximate Synonyms:
- Elevated PSA levels
- Increased prostate-specific antigen
- Abnormal PSA test results
- Raised PSA concentration
- Elevated prostate specific antigen (psa) measurement
- Raised prostate specific antigen
Remember: Reimbursement claims dated on or after October 1, 2015, require the use of ICD-10-CM codes.
Frequently Asked Questions (FAQ):
What is the ICD-10 code for elevated PSA?
The ICD-10 code R97.20 classifies prostate-specific antibodies with elevated PSA levels. When the PSA levels exceed normal, healthcare professionals can use this code to raise flags about possible prostate problems such as benign prostate hyperplasia (BPH), prostatitis, or even cancer. These elevated PSA levels indicate possible symptoms that warrant investigation and monitoring by healthcare professionals.
What is elevated PSA R97.20?
An elevated PSA of R97.20 indicates an abnormality in the laboratory, suggesting increased prostate-specific antigen (PSA). Both malignant and normal cells of the prostate gland produce PSA, and elevated levels may not always indicate cancer; further investigation is necessary to understand possible causes of such elevation, such as prostatitis or an enlarged prostate, as they could indicate more serious conditions like prostate cancer.
What is elevated PSA?
“Excessive” PSA refers to any condition wherein PSA levels exceed their normal range in blood. The prostate gland releases PSA, and while low levels may suggest normal health, elevated levels could signify abnormalities such as inflammation, infection, or even cancer. Early diagnosis and treatment of any potential prostate-related health issues are crucial.
What is the ICD-10 code for R97.21?
The ICD-10 code R97.21, we use R to refer to irregular findings of elevated cancer-associated antigen (CA 125) levels, commonly measured to detect specific cancer types like ovarian cancer. Higher CA levels could indicate increased cancer risks, as well as diseases like endometriosis, pelvic inflammation disease, or menstrual flow. Using this code helps healthcare providers recognize irregular CA 125 findings so as to provide proper diagnosis and treatment solutions.
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