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Test Code 149 Prostate Specific Antigen (PSA), Total

Important Note

Manipulation of the prostate by rectal examination within 48 hours of specimen collection may result in elevated results. 5 alpha-reductase inhibitor drups may affect PSA levels.

Human anti-mouse antibodies (hama) may be present in samples from patients who have received immunotherapy or diagnostic procedures utilizing monoclonal antibodies or in individuals who have been regularly exposed to animals. Additionally, other heterophile antibodies, such as human anti-goat antibodies may be present in patient samples. Manufacturers formulate assays to minimize the effects of these antibodies; however careful evaluation of patient results must be done when patients are known to have such antibodies.

Additional Codes

ALAB: PSAT

PowerChart: Prostate Specific Antigen Screening

MA Cerner: Prostate Specific Ag

Test Method

MercyOne: Equimolar Two-Site Immunoenzymatic "Sandwich" Assay; Beckman DxC700AU

MA: Immunoenzymatic ("Sandwich") Chemiluminescent Method; Roche Cobas 6000

Specimen Requirement

MercyOne: 0.5 mL serum required.

MA: 0.5 mL serum or lithium heparin plasma

Additional Specimen Collection Information

MercyOne: Collect blood in a red-top tube. SST (serum gel tubes) are acceptable. Serum should be separated from contact with the cells within 2 hours of collection. Specimens not analyzed within 3 hours of collection must be refrigerated. If a specimen is to be stored longer than 24 hours it must be stored frozen at -20°C.

MA: Collect blood in a PST tube. SST (serum gel tubes) and red top tubes are acceptable. Serum/plasma should be separated from contact with the cells within 2 hours of collection. Specimens not analyzed within 3 hours of collection must be refrigerated. Specimen can be stored for 5 days at 2-8°C and 6 months at -20°C. Frozen samples should be thawed only once. 

Performance

Testing is performed Monday through Sunday.

Routine: Typically completed within 4 hours after the specimen arrives at the testing site.

Expedite: Typically completed within 1 hour after the specimen arrives at the testing site.

STAT: Typically completed within 30 minutes after the specimen arrives at the testing site.

Reference Values

MercyOne:
Female: < 0.2 ng/mL

Male:

Age, Years

Total PSA ng/mL

Age, Years

 

Total PSA ng/mL

Age, Years

 

Total PSA ng/mL

≤ 40

0-2.0

54

0-3.2

68

0-4.9

41

0-2.1

55

0-3.3

69

0-5.1

42

0-2.2

56

0-3.4

70

0-5.3

43

0-2.3

57

0-3.5

71

0-5.4

44

0-2.3

58

0-3.6

72

0-5.6

45

0-2.4

59

0-3.7

73

0-5.8

46

0-2.5

60

0-3.8

74

0-6.0

47

0-2.6

61

0-4.0

75

0-6.2

48

0-2.6

62

0-4.1

76

0-6.4

49

0-2.7

63

0-4.2

77

0-6.6

50

0-2.8

64

0-4.4

78

0-6.8

51

0-2.9

65

0-4.5

79

0-7.0

52

0-3.0

66

0-4.6

≥ 80

0-7.2

53

0-3.1

67

0-4.8

 

 

Post prostatectomy: < 0.1 ng/mL

MA: 
Female: N.A.

 Age: (Years)  PSA: (ng/mL)

 <40    

  0.0-2.0   
 40-49    0.0-2.5
50-59  0.0-3.5
60-69  0.0-4.5
70-79  0.0-6.5
≥ 80  0.0-7.2

Post prostatectomy: < 0.1 ng/mL

CPT Code Information

84153 Chemistry: Prostate specific antigen; total

G0103 for Medicare billing

NCD Frequency Limitations: Medicare covers a screening total PSA test one each year for men over 50 years of age.

 

BCBS requires a signed ABN. (For men < 50 yrs of age.)

Useful For

Monitoring patients with a history of prostate cancer as an early indicator of recurrence and response to treatment

Prostate cancer screening

LOINC Code Information

2857-1 Prostate specific Ag [Mass/volume] in Serum or Plasma