PSA, Free and Total

Test Code
31348


CPT Codes
84153, 84154

Includes
PSA, Total
PSA, Free
PSA, % Free


Preferred Specimen
2 mL serum


Minimum Volume
0.6 mL


Instructions

Do not collect specimen after a transrectal biopsy, results may be falsely elevated



Transport Container
Plastic screw-cap vial


Transport Temperature
Frozen


Specimen Stability
Room temperature: 72 hours
Refrigerated: 72 hours
Frozen: 5 months


Methodology
Immunoassay (IA)

Setup Schedule
Set up: Tues-Sat evening; Report available: Same day


Limitations
Based on solid evidence, screening with PSA and/or DRE detects some prostate cancers that would never have caused important clinical problems. Current prostate cancer treatments, including radical prostatectomy and radiation therapy, result in permanent side effects in many men. The most common of these side effects are erectile dysfunction and urinary incontinence. Whatever the screening modality, the screening process itself can lead to adverse psychological effects in men who have a prostate biopsy but do not have identified prostate cancer. Prostatic biopsies are associated with complications, including fever, pain, hematospermia/hematuria, positive urine cultures, and rarely sepsis.


Reference Range
PSA, Total
Male ≤4.0 ng/mL
Female Not established

PSA, Free See Laboratory Report

PSA, % Free
Male >25 % (calc)
Female Not established


Clinical Significance
In men over 50 years with total PSA between 4.0 and 10.0 ng/mL, the percent (%) free PSA gives an estimate of the probability of cancer. In these circumstances the measurement of the % free PSA may aid in avoiding unnecessary biopsies.

Elevated levels of Prostate Specific Antigen (PSA) have been associated with benign and malignant prostatic disorders. Studies indicate that in men 50 years or older measurement of PSA is a useful addition to the digital rectal exam in the early detection of prostate cancer. In addition, PSA decreases to undetectable levels following complete resection of the tumor and may rise again with recurrent disease or persist with residual disease. Thus, PSA levels may be of assistance in the management of prostate cancer patients.


Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153




The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.