PSA, Free

CPT: 84154

Expected Turnaround Time

24 hours

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Specimen Requirements

Specimen

Serum

Volume

5 ml

Minimum Volume

25 ul

Container

SST (Serum), Red Top (Separate Serum)

Storage Instructions

Room Temp., Refrigerated (2-8 C)

Stability Requirements

Room temp. 7 days, Refrigerated 7 days

Causes for Rejection

Mislabeled specimen, grossly hemolyzed specimen, sample collected expired tubes, clotted specimen, samples out of stability.

Test Details

Use

It is use for quantitative measurement of free prostate-specific antigen (PSA) not bound to α1 antichymotrypsin or other binding proteins (uncomplexed) in human serum.

Methodology

chemiluminescent immunometric assay.

Reference Interval

<0.7 ng/ml

Additional Information

PSA is a protein produced predominantly by cells in the prostate, a tiny gland that surrounds the urethra in males and generates a fluid that is a component of semen. The majority of PSA produced by the prostate is discharged into this fluid, but minor amounts can also be found in the blood. PSA levels in the blood increase when someone has prostate cancer, an infection, or a condition called benign prostatic hypertrophy (BPH) or benign prostatic enlargement (BPE), a condition that is not cancer.   

Prostate-specific antigen (PSA) circulates in the blood in two main forms: bound to proteins and unbound (free). Free PSA (fPSA) refers to the unbound fraction and is measured directly in serum, with results reported in ng/mL. Free PSA levels can provide additional information when evaluating prostate health. Studies have shown that men with prostate cancer tend to have lower concentrations of free PSA compared to those with benign conditions such as benign prostatic hyperplasia (BPH). Thus, measuring free PSA may improve the clinical assessment of prostate disorders, particularly in patients with borderline or moderately elevated total PSA levels.

References:

  1. Christensson A, et al. Serum prostate specific antigen complexed to α1-antichymotrypsin as an indicator of prostate cancer. J Urol. 1993;150(1):100–105.

  2. Lilja H, et al. Prostate-specific antigen and prostate cancer: prediction, detection and monitoring. Nat Rev Cancer. 2008;8(4):268–278.

  3. American Urological Association (AUA) Guideline: Early Detection of Prostate Cancer. 2023.

  4. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Should I Get Screened for Prostate Cancer? [reviewed 2021 Aug 23; cited 2022 May 16]; [about 2 screens]. Available from: https://www.cdc.gov/cancer/prostate/basic_info/get-screened.htm 
  5. Arcangeli CG, Humphrey PA, Smith DS.  et al.  Percentage of free serum prostate-specific antigen as a predictor of pathological features of prostate cancer in a screening population.  Urology.1998;51:558-564. 

Footnotes

Statement on Medical Necessity
All ordered tests should be medically necessary for the diagnosis or detection of disease, illness, impairment, symptom, syndrome, or disorder and the results should be used in the medical management and treatment decisions for the patient. Solaris requires ICD-10 codes with each order for lab testing and both the tests ordered and the diagnosis should be documented in the provider’s medical record for the patient. The United States Department of Health and Human Services, Office of Inspector General, takes the position that a provider who orders medically unnecessary tests may be subject to civil penalties.

Panels and Profiles
Solaris offers Providers the convenience of ordering test combinations in a group at times with the flexibility to choose appropriate test(s) for individual patients. Providers should only order those tests that he or she believes are medically necessary for each patient, and a lesser inclusive profile or individual tests should be ordered if not all tests in the test combination/profile are medically necessary. All tests offered in a test combination/profile may be ordered separately as individual tests. Solaris encourages clients to contact their Solaris representative if the testing configurations shown do not meet individual needs for any reason, or if some other combination of procedures is needed.

CPT Codes
CPT Codes listed are in accordance with Current Procedural Terminology, a publication of the American Medical Association. CPT codes are the responsibility of the billing party and are listed here for informational purposes. Correct coding may vary from one carrier to another. Solaris may bill specific carriers using codes other than what is shown.

Questions?

For questions or inquiries related to testing please reach out to
customerservice@solarisdx.com or contact us by phone at (844) 550-0308.