icd 10 code for 4k score

What is the CPT code for 4kscore test?

4Kscore (Prostate-Specific Kallikrein) Test Code. Test Name. 2014059. 4Kscore (Prostate-Specific Kallikrein) The 4Kscore Test is recommended for men concerned with their risk for high-grade, aggressive prostate cancer and is especially useful when considering a prostate biopsy.

What is the 4K score test for prostate cancer?

The 4Kscore Test is recommended for men concerned with their risk for high-grade, aggressive prostate cancer and is especially useful when considering a prostate biopsy. The 4Kscore Test measures four biomarkers: total PSA, free PSA, intact PSA, and hK2.

What are the key features of the 4K score test?

4Kscore Test highlights: 1 Non-invasive 2 Looks at four prostate-specific biomarkers 3 Predicts risk of high-grade prostate cancer 4 Predicts long-term risk of distant metastasis 5 Reduces overtreatment and unnecessary biopsies 6 Allows physicians to make better treatment decisions for their patients

How do I get a 4kscore® test?

the next steps regarding your prostate health. 4Kscore® requires a blood sample taken at your physician's office or at a local blood draw facility. Find a 4Kscore® Test collection center in your area.

What is the ICD 10 code for prostate screening?

ICD-10 code Z12. 5 for Encounter for screening for malignant neoplasm of prostate is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

What is the CPT code for 4Kscore test?

Article - Billing and Coding: 4Kscore Test Algorithm (A56287)

What does my 4k score mean?

The 4Kscore® Test result is the probability of finding high-grade, aggressive prostate cancer (Gleason 7 or higher) if a prostate biopsy were to be performed. A 4Kscore® <5.0 is associated with decreased likelihood of a Gleason score ≥7 on biopsy. Prostate biopsy is required for the diagnosis of cancer.

Is 4k blood test covered by insurance?

The 4Kscore® Test is covered by most leading healthcare insurance plans. We will bill a patient's insurance company, and the patient will only be responsible for applicable copayment, co-insurance, and/or deductible amounts.

Does Medicare pay for 4KScore test?

Medicare will cover the 4Kscore® test when it is deemed to be medically necessary, based on specific findings in previous tests and only in men over the age of 45.

How much does the 4KScore test cost?

The 4KScore test costs $395; PCPT is free.

What does low 4Kscore mean?

A low 4Kscore Test result (< 7.5%) usually indicates that a prostate biopsy can be safely deferred. The 4Kscore Test is indicated for men who have never undergone a prostate biopsy (ie, biopsy naive) or have had a prior biopsy with no cancer detected.

How accurate is the 4Kscore Test?

No significant difference in 4Kscore® accuracy between African American and non-African American men. Sensitivity of 97% and Negative Predictive Value (NPV) of 95% for the detection of aggressive prostate cancer. 22% of study subjects could avoid or delay biopsies.

Is 4k test accurate?

4Kscore test helps avoid needless biopsies Cleveland Clinic has recently begun offering a new test that is highly accurate in screening men for prostate cancer, especially for the risk of high-grade cancers that warrant aggressive treatment.

What ICD 10 code covers PSA screening?

*October 2017 Changes. ICD-10-CM Version – Red. ... Fu Associates, Ltd. ... 190.31 - Prostate Specific Antigen. ... Total PSA. ... Prostate Specific Antigen (PSA), a tumor marker for adenocarcinoma of the prostate, can predict residual tumor in the post-operative phase of prostate cancer. ... © ... Code. ... ICD-10-CM Codes Covered by Medicare Program.More items...

What diagnosis covers PSA for Medicare?

Prostate cancer screenings. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. covers digital rectal exams and prostate specific antigen (PSA) blood tests once every 12 months for men over 50 (starting the day after your 50th birthday).

What diagnosis will cover PSA screening?

PSA when used in conjunction with other prostate cancer tests, such as digital rectal examination, may assist in the decision making process for diagnosing prostate cancer. PSA also, serves as a marker in following the progress of most prostate tumors once a diagnosis has been established.

What is the 4k score?

The 4Kscore Test is recommended for men concerned with their risk for high-grade, aggressive prostate cancer and is especially useful when considering a prostate biopsy . The 4Kscore Test measures four biomarkers: total PSA, free PSA, intact PSA, and hK2.

Can a 4kscore test detect prostate cancer?

While the 4Kscore Test can’t provide a prostate cancer diagnosis, it can help physicians and their patients decide whether or not to perform a biopsy based on ...

Document Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

This local coverage determination (LCD) supplements but does not replace, modify or supersede existing Medicare applicable National Coverage Determinations (NCDs) or payment policy rules and regulations for 4Kscore Test Algorithm. Federal statute and subsequent Medicare regulations regarding provision and payment for medical services are lengthy.

Coverage Guidance

The 4Kscore test measures blood levels of four Kallikreins protein biomarkers (total prostate-specific antigen [tPSA], free PSA [fPSA], intact PSA [iPSA], and human Kallikrein-related peptidase 2 [hK2]) in addition to other clinical information, including age, digital rectal examination (DRE) and prior biopsy history.

Interpretation of Results

The 4Kscore® test helps provide diagnostic clarity for patients with an elevated PSA result or other clinical finding suggestive of prostate cancer.

Patient Considerations

The 4Kscore® test is especially useful for biopsy decision clarification in patients whose other test results are equivocal.

Looking for more information?

With the 4Kscore®, healthcare providers can improve clinical decision making and give patients peace of mind regarding their risk for aggressive prostate cancer. Please speak with your sales representative or click the link below to download the 4Kscore® healthcare provider resource.

What is a 4k score?

The 4Kscore is the only blood test that accurately identifies an individual patient’s risk for aggressive prostate cancer, the lethal form of prostate cancer.

What is a CPT code?

In addition to facilitating reimbursement in government programs such as Medicare and Medicaid, CPT codes are used by other insurance companies and government payers to describe health care services and procedures.

What is a 4k score?

A 4K score (or 4Kscore test) is a combination of blood tests and other clinical factors to create a comprehensive risk analysis. The results from a 4K score help determine the risk of developing an aggressive form of prostate cancer.

What is a 4k prostate test?

4K scores are used to determine a man’s risk of having or developing aggressive prostate cancer. 4K scores and prostate MRIs are both noninvasive ways to more accurately screen for prostate cancer. The PSA test is helpful but can often lead to excessive prostate biopsies.

What is the Gleason score for prostate cancer?

The grades range from 1-5, so the Gleason score results range from grades 2-10. An aggressive form of prostate cancer, or high risk, is categorized as a Gleason 7 or greater.

What is the standard blood test for prostate cancer?

The standard screening blood test for prostate cancer is the prostate-specific antigen (PSA). The American Cancer Society recommends men have a discussion with their primary care provider when they turn 50 about whether or not to start routine PSA testing.

What are the four biomarkers measured?

The four blood tests, or biomarkers, measured are: Total PSA. Free PSA. Intact PSA. Human kallikrein 2 (hK2) Once the blood tests and other factors are taken into an account, the results are sent to a lab to be evaluated. Then, a report is created for you and your healthcare provider to review.

Can you send a 4k score to a lab?

If your provider wants to know your 4K score and they don’t offer testing in their own clinic and lab, they can send an order to a 4k score location to complete the test. The results will then be sent to your provider for review.

Do you need a 4k blood test?

For the patient, a 4K test is no different than any other blood test done at your physician’s office. However, not all physicians carry the 4K score testing kit required. Patients should look for a 4K score draw center where they can have the testing done.