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July 07, 2020

Coding Corner | Prostate Cancer Screening

Screening Digital Rectal Examination
Screening digital rectal examination means a clinical examination of an individual’s prostate for nodules or other abnormalities of the prostate. This screening must be performed by a doctor of medicine or osteopathy (as defined in §186l(r)(1) of the Act), or by a physician assistant, nurse practitioner, clinical nurse specialist, or by a certified nurse-midwife (as defined in §1861(aa) and §1861(gg) of the Act), who is authorized under State law to perform the examination, fully knowledgeable about the beneficiary, and would be responsible for explaining the results of the examination to the beneficiary.

Screening Prostate Specific Antigen (PSA) Tests
Screening prostate-specific antigen (PSA) is a test that measures the level of prostate-specific antigen in an individual’s blood. This screening must be ordered by the beneficiary’s physician or by the beneficiary’s physician assistant, nurse practitioner, clinical nurse specialist, or certified nurse-midwife (the term “physician” is defined in §1861(r)(1) of the Act to mean a doctor of medicine or osteopathy and the terms “physician assistant, nurse practitioner, clinical nurse specialist, or certified nurse-midwife” are defined in §1861(aa) and §1861(gg) of the Act) who is fully knowledgeable about the beneficiary, and who would be responsible for explaining the results of the test to the beneficiary.

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