Prostate Cancer Awareness Month
Published on
Wednesday, September 1, 2021
September is Prostate Cancer Awareness Month. A related RealTime Medicare Data (RTMD) infographic in this week’s newsletter focuses on Medicare Fee-for-Service claims data related to screening for Prostate Cancer.
Did You Know?
According to the CDC:
- 13 out of every 100 American men will get prostate cancer during their lifetime, and
- 2 to 3 men will die from prostate cancer,
- If you are African American or have a family history of prostate cancer you are at increased risk for getting or dying from prostate cancer.
The NIH National Cancer Institute indicates that based on 2011-2017 data, there is a 97.5% 5-year relative survival rate for men diagnosed with prostate cancer.
Why Does this Matter? Know the Symptoms
The CDC advises that if you are having any of the following symptoms, you need to see your doctor right away:
- Difficulty starting urination.
- Weak or interrupted flow of urine.
- Frequent urination, especially at night.
- Difficulty emptying the bladder completely.
- Pain or burning during urination.
- Blood in the urine or semen.
- Pain in the back, hips, or pelvis that doesn’t go away.
- Painful ejaculation.
The NIH National Cancer Institute indicates that based on 2011-2017 data, there is a 97.5% 5-year relative survival rate for men diagnosed with prostate cancer.
What You Can Do About It? Screening for Prostate Cancer
There are two tests commonly used to screen for prostate cancer:
- A blood test called a prostate specific antigen (PSA) test and
- A digital rectal examination (DRE).
The U.S. Preventive Services Task Force recommendation is that men aged 55 to 69 years should participate in a shared decision making process with their physician by discussing the potential benefits and harms of screening with a PSA test and incorporating their values and preferences in the decision.
This recommendation applies to men who:
- Are at average risk for prostate cancer,
- Are at increased risk for prostate cancer,
- Do not have symptoms of prostate cancer, and
- Have never been diagnosed with prostate cancer.
Medicare Preventive Service: Prostate Cancer Screening – Coverage & Coding
HCPCS & CPT Codes
- G0102 (Prostate cancer screening; digital rectal exam): A patient’s copayment or coinsurance, and deductible will apply.
- G0103 (Prostate cancer screening; prostate specific antigen test): there is no copayment, coinsurance, or deductible for the patient.
Resources:
Article Author: Beth Cobb, RN, BSN, ACM, CCDS
Beth Cobb, RN, BSN, ACM, CCDS, is the Manager of Clinical Analytics at Medical Management Plus, Inc. Beth has over twenty-five years of experience in healthcare including eleven years in Case Management at a large multi-facility health system. In her current position, Beth is a principle writer for MMP’s Wednesday@One weekly e-newsletter, an active member of our HIPAA Compliance Committee, MMP’s Education Department Program Director and co-developer of MMP’s proprietary Compliance Protection Assessment Tool.
