Other tests utilizing systems pathology that uses cellular and biologic features of a tumor is experimental and investigational, including use in predicting risk of recurrence in patients with prostate cancer.Other screening tests for prostate cancer, including, but not limited to, alphamethylacyl coenzyme A racemase (AMACR), early prostate cancer antigen, endoglin, E twenty-six (ETS) gene fusions, human kallikrein 2, analysis of prostatic fluid electrolyte composition, interleukin-6, transforming growth factor-beta 1, TMPRSS2:ERG gene fusion, and gene hypermethylation, are experimental and investigational because their clinical utility has not been proven.Routine prostate cancer screening using percent free PSA, free-to-total PSA ratio, and complexed PSA tests.Use of percent free PSA, 4Kscore, Prostate Health Index (PHI), PCA3 score or ConfirmMDx as a first-line screening test for prostate cancer.Testing in the following situations is considered experimental and investigational:.PSA testing meets coverage criteria for follow-up of individuals with a current or previous diagnosis of prostate cancer, and for ongoing monitoring of individuals who have undergone tumor resection or prostatectomy.African-American individuals and individuals with a family history of prostate cancer or individuals with a presence of inherited mutations). PSA testing annually meets coverage criteria for individuals with signs or symptoms of prostate cancer or in high-risk populations (eg.Follow-up testing with percent free PSA meets coverage criteria in patients thought to be at a higher risk despite at least one prior negative prostate biopsy.Follow-up in 6-12 months with PSA or DRE.For individuals aged 45-75 years, PSA 3 ng/ml or very suspicious DRE: Any one of the following meets coverage criteria.Repeat testing for prostate cancer meets coverage criteria for individuals with previous PSA results with the following frequency:. ![]() For individuals over 75 years, screening with a PSA test is considered Medically Necessary only for very healthy individuals with little or no comorbidities. ![]()
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