Health Lab

Test Name:

PROSTATE SPECIFIC ANTIGEN (PSA), REFLEX FREE PSA

Test Code:

2120337

Alias:

LAB3059
PSA, Reflex Free PSA

CPT Code(s):

84153

Preferred Specimen:

1.0 mL serum

Container:

SST (gold)

Alternate Container:

Minimum Volume:

0.3 mL serum
This volume does not allow for repeat testing.

Collection Instructions:

Allow specimen to completely clot (this can take up to 60 minutes). Centrifuge for 15 minutes.

Transport Temperature:

Refrigerated

Stability:

Room temperature: 72 hours*

Refrigerated: 5 days

Additional Information:

The Free PSA result and % free PSA is reported ONLY if the Total PSA result is between 4 – 10 ng/ml. If a Free PSA is performed, an additional charge and CPT (84154) will apply.

Specimens for PSA testing should be drawn prior to such prostatic manipulations as digital rectal examination (DRE), prostatic massage, transrectal ultrasound, and prostatic biopsy. DRE may cause a transient increase in serum PSA levels.

Schedule:

Set up Daily: Results in 24-48 hours

Method:

Electrochemiluminescence Immunoassay (ECLIA)

Clinical Significance:

Prostate cancer is the most common type of cancer found in men. Measurement of PSA is useful in the differentiation of prostate cancer from benign prostatic conditions. In patients with elevated PSA concentrations, men with prostate cancer tend to have lower percent free PSA/total PSA than men with benign disease. This difference in the distribution of percent free PSA values in men with and without cancer may be used to select cutoffs for biopsy decisions, maintaining 90 - 95% sensitivity, while sparing 20 - 30% of men with benign disease from biopsy. Percent free PSA may also be used for risk assessment, to determine the probability of cancer for an individual patient. Lower percent free PSA values are associated with higher risk of cancer.

Use:

Updated 08/15/2023

Reference Ranges:

Probability of finding PCA on needle biopsy by age in years
% fPSA ratio	50-59	60-69	>70
< 10	49.2%	57.5%	64.5%
11-18	26.9%	33.9%	40.8%
19-25	18.3%	23.9%	29.7%
>25	9.1%	12.2%	15.8%

Reference Range Table

Result	Units	Gender	Age	Range
Free PSA %	percent	Both	0 Year - 999 Year	25-100
PSA, Total	ng/mL	Both	0 Year - 999 Year	0.000-4.00
PSA, Free	ng/mL	Both	0 Year - 999 Year	0.000-0.900

The CPT codes included in this publication are in accordance with Current Procedural Terminology, a publication of the American Medical Association. CPT codes are provided here for the convenience of our clients; however, correct coding often varies from one carrier to another, and HealthLab may bill specific carriers using codes other than those shown. Clients who bill for services should verify the code(s) with the applicable payor to confirm that their use is appropriate in each case.