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Test Code PSA-D PSA,DIAGNOSTIC

Important Note

Test subject to Medicare National Coverage Determination (NCD).

See Medical Necessity documentation requirements by clicking on  

Medicare National Coverage Determinations under General Information

to left of this screen.

Additional Codes

LAB116

Performing Laboratory

Porter Hospital Laboratory

Specimen Requirements

Specimen Type: Blood
Container/Tube: Tiger top, serum gel
Also Acceptable: Green top (Lithium Heparin)
Specimen Volume: Full tube, 1.0 mL
Specimen Minimum Volume: 0.5 mL
Collection Instructions:
  1. Send specimen in original tube.
  2. If there is a delay in transport of >1 hour, centrifuge tube.
  3. Centrifuged samples are stable for 7 days refrigerated (2 – 8ºC)

Specimen Transport Temperature

Refrigerated

Test Classification and CPT Coding

84153

Test Schedule / Analytical Time / Test Priority / Turn Around Time

M-F / Same day / Not Available STAT / Routine - 4 Hours

Normal Reference Values

0 up to 50 years   ≤2.500 ng/mL
50 years up to 60 years   ≤3.500 ng/mL
60 years up to 70 years   ≤4.500 ng/mL
70 years to unspecified   ≤6.500 ng/mL

Critical Values

None

Specimen Requirements Additional Information

Use when patient is having symptoms along with appropriate Diagnostic Code(s).