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Preventive Services: Prostate Cancer Screening

By:  Find-A-Code
Published:  September 1st, 2017

The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Prostate Cancer Screening: 

HCPCS/CPT Codes

G0102 - Prostate cancer screening; digital rectal examination (DRE)
G0103 - Prostate cancer screening; prostate specific antigen test (PSA)

ICD-10 Codes

Z12.5

Who Is Covered

All male Medicare beneficiaries aged 50 and older (coverage begins the day after 50th birthday)

Frequency

Annually

Medicare Beneficiary Pays

G0102:

  • Copayment/coinsurance applies
  • Deductible applies

G0103:

  • Copayment/coinsurance waived
  • Deductible waived

Please note: The information in this educational product applies only to the Medicare Fee-For-Service Program (also known as Original Medicare). For additional guidance on using diagnosis codes, go to the Medicare Claims Processing Manual, Chapter 18 on the Centers for Medicare & Medicaid Services (CMS) website.

Watch the CMS Provider Minute: Preventive Services video for pointers to help you submit sufficient documentation when billing for certain preventive services.


References:

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