| HCPCS Code: |
G0103 |
| Long Description: |
Prostate cancer screening; prostate specific antigen test (psa) |
| Short Description: |
Psa screening |
| Pricing Indicator 1: |
21 (Price subject to national limitation amount) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Coverage Issues Manual 1: |
50-55 |
| MCM Reference Section Number 1: |
4182 |
| Statute Number: |
|
| Lab Certification Code 1: |
310 (Routine chemistry) |
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
0064 |
| Berenson-Eggers Type of Service (BETOS) Code: |
T1H (Lab tests - other (non-Medicare fee schedule)) |
| Type of Service Code 1: |
5 (Diagnostic laboratory) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-2000 |
| Action Effective Date: |
01-01-2007 |
| Action Code: |
N (No maintenance for this code) |
