The current national coverage determination (NCD) for Prostate Specific Antigen includes in the list of “ICD-9-CM Codes Covered by Medicare” code 599.6 for urinary obstruction. Effective October 1, 2003, ICD-9-CM added a new code, 600.01, for benign prostatic hypertrophy (BPH) with urinary obstruction. It is no longer appropriate coding to code urinary obstruction separately on a beneficiary with BPH. We have been requested to add code 600.01 to the list of codes covered by Medicare for prostate specific antigen tests. We will be reviewing this code more carefully with the benefit of public comment to make a determination.
