Coding and Billing for Diagnosis and Treatment of Prostate Cancer

Ferragamo, Michael A.

doi:10.1016/b978-0-12-800077-9.00063-3

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Following existing literature and guidelines, we defined prostate-related MRI as claims reporting a pelvic MRI (CPT codes: 72195, 72196, 72197) with a relevant prostate indication code (ICD [International Classification of Diseases]-9 and ICD-10 codes are reported in Supplementary Table 1, https://www.urologypracticejournal.com) and defined biopsy of the prostate as CPT codes 55700 and G0416. 12-14 Finally, because urinary tract infections are another common cause of elevated PSA levels, 15,16 patients who underwent testing for urinary tract infection (CPT codes: 87186, 87088, 87077) within 6 weeks before an elevated PSA test were removed from the sample. The data used in this study are not available because they are proprietary data that contain personally identifiable information.…”

Section: Methodsmentioning

confidence: 99%

“…urologypracticejournal.com) and defined biopsy of the prostate as CPT codes 55700 and G0416. [12][13][14] Finally, because urinary tract infections are another common cause of elevated PSA levels, 15,16 patients who underwent testing for urinary tract infection (CPT codes: 87186, 87088, 87077) within 6 weeks before an elevated PSA test were removed from the sample. The data used in this study are not available because they are proprietary data that contain personally identifiable information.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

An Examination of Racial and Ethnic Disparities in the Use of Prostate Biopsy and Magnetic Resonance Imaging in Prostate Cancer Screening

et al. 2023

View full text Add to dashboard Cite

Study Need and Importance: Prostate cancer (PCa) is the second most common cancer diagnosis in men, particularly affecting Black men, who experience higher incidence and mortality rates compared to other racial groups. This study investigated racial and ethnic disparities in the utilization of follow-up testing (biopsy or MRI) after an abnormal PSA result. What We Found: Using insurance claims data from a sample of 765,409 male patients, we observed that Black men were more likely to undergo follow-up testing after an elevated PSA result compared to White men, which is congruent with their relative PCa risk. Additionally, Asian and Hispanic men had lower rates of follow-up testing compared to White men, which is also congruent with their relative PCa risk. These disparities were consistent across different age groups, but most pronounced among patients aged 65-74.Limitations: This study utilized retrospective claims data for patients enrolled in a single health plan, and the data did not include detailed clinical information such as disease severity or patient preferences. Additionally, the data are proprietary and are not available for further analysis. Interpretation for Patient Care: Our findings suggest that physicians rely on the reported statistical incidence of PCa among different racial and ethnic groups to guide decision-making for follow-up testing in patients with elevated PSA levels. Notably, our findings highlight that Black men have the highest likelihood of undergoing a follow-up prostate test, followed by White, Hispanic, and Asian patients. These results underscore the significance of publishing statistical data on disease incidence categorized by race and ethnicity, as the data play a critical role in informing physician decision-making and risk stratification.

show abstract

Section: Methodsmentioning

confidence: 99%