Summary & Overview
CPT 84152: Complexed Prostate Specific Antigen (cPSA) Measurement
CPT code 84152 denotes the laboratory assay for complexed prostate specific antigen (cPSA), a blood-based marker produced by the prostate and commonly used in the clinical evaluation related to prostate cancer. Nationally, cPSA testing contributes to diagnostic workflows, risk stratification, and monitoring strategies in urology and oncology, and its billing impacts laboratory utilization and payer coverage policies.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for cPSA testing, the typical service environment (clinical and hospital laboratories), and the practical billing considerations tied to CPT code 84152.
This publication provides benchmarks and payer coverage patterns where available, summarizes relevant policy developments affecting laboratory test reimbursement, and outlines common clinical indications and testing workflows for cPSA. The content is intended to help coding professionals, laboratory managers, and policy analysts understand how CPT code 84152 fits into national laboratory billing and clinical practice. Data not available in the input for detailed payer-specific rates, ICD-10 mappings, and related codes.
Billing Code Overview
CPT code 84152 represents laboratory measurement of complexed prostate specific antigen (cPSA) by direct assay, typically performed on serum or plasma samples using automated laboratory analyzers. cPSA is a protein produced by the prostate gland and is most often measured in the context of evaluation for prostate cancer or related prostate disease.
Service Type: Laboratory diagnostic test (clinical chemistry/immunoassay)
Typical Site of Service: Clinical laboratory or hospital laboratory
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is a male aged 50–75 with an elevated serum total prostate-specific antigen (PSA) or an abnormal digital rectal exam. The clinician orders 84152 (complexed PSA, cPSA) to help assess prostate cancer risk and to complement total PSA and free PSA results. The patient presents to an outpatient laboratory or hospital phlebotomy suite; a venous blood sample (serum or plasma) is collected, labeled, and sent to the clinical laboratory. The laboratory analyst performs the assay on automated immunoassay analyzers, documents results in the laboratory information system, and reports values to the ordering clinician. Follow-up actions may include urology referral, repeat testing, prostate biopsy, or active surveillance decisions based on combined PSA metrics and clinical findings.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation/reporting portion from a physician for ancillary lab services requiring physician interpretation. |
TC | Technical component |