What is the ICD-10 (International Classification of Diseases, 10th Revision) code for an elevated Prostate-Specific Antigen (PSA) level in an adult male patient?

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ICD-10 Code for Elevated PSA

The ICD-10 code for an elevated prostate-specific antigen (PSA) level is R97.20 (Elevated prostate specific antigen [PSA]).

Primary Coding

  • R97.20 is the specific code for elevated PSA and should be used when documenting an abnormal PSA test result in adult male patients 1

Related ICD-10 Codes You May Need

  • Z12.5 - Encounter for screening for malignant neoplasm of prostate (use this when the PSA test is performed as part of routine prostate cancer screening) 1

  • N40.0 - Benign prostatic hyperplasia without lower urinary tract symptoms (if BPH is contributing to PSA elevation) 2

  • C61 - Malignant neoplasm of prostate (use only after biopsy-confirmed prostate cancer diagnosis) 2

  • Z85.46 - Personal history of malignant neoplasm of prostate (for post-treatment PSA monitoring) 2, 1

Clinical Context for Coding

  • Approximately 30-35% of men with PSA between 4-10 ng/mL will have cancer on biopsy, while two-thirds of elevated PSA values are due to benign conditions like BPH 2

  • When PSA is >50 ng/mL, the positive predictive value for prostate cancer is 98.5%, which may influence your diagnostic coding approach 3

  • For post-treatment monitoring, use R97.20 in conjunction with Z85.46 when PSA rises after radical prostatectomy (≥0.4 ng/dL) or radiation therapy (>1.5 ng/dL above nadir) 1

Documentation Tips

  • Always document the actual PSA value in ng/mL alongside the ICD-10 code, as this affects clinical decision-making and risk stratification 2

  • Note any confounding factors such as recent prostate manipulation, active UTI, or use of 5-alpha reductase inhibitors (finasteride/dutasteride), which can affect PSA levels and may require additional coding 1

  • Include PSA velocity if available (≥1.0 ng/mL per year is significant), as this may warrant additional diagnostic codes even with "normal" absolute PSA values 1

References

Guideline

Management of Elevated PSA

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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