Last Modified:
8/21/2023 2:58:45 PM
Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Patient should discontinue taking Biotin, Vitamin B7, or Vitamin H 48 hours before getting blood drawn.
Specimen Requirements:
1.0 mL Serum in a SST Gold Top Tube
Collection Instructions:
Transport & Storage: Temperature/Stability:
48 hours Refrigerated
> 48 hours Frozen
Reference Range:
0.0 - 4.0 ng/mL
Critical Ranges:
Test Comments:
A Free PSA will be ordered and charged when the PSA results are > 4.0 or <10.0.
Patients taking vitamin supplements containing doses of >5 mg/day may have falsely decreased test results generated.
Methodology:
Chemiluminescence ECLIA
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Regional Medical Center
PHL Test Code:
PSAR
EPIC Test Code:
LAB2313
Alternate Test Names:
PSA Free if indicated; PSA with Free PSA Reflex
Included Tests:
CPT Coding:
84153 (Reflexes 84154)
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