Prostate Cancer Screening
HCPCS/CPT Codes
G0102 – Digital Rectal Exam (DRE)
G0103 – Prostate Specific Antigen Test (PSA)
ICD-10-CM Codes
Z12.5
Who Is Covered
All male Medicare beneficiaries aged 50 and older (coverage begins the day after their 50th birthday)
Frequency
Annually for covered beneficiaries
Beneficiary Pays
G0102:
• Copayment/coinsurance applies
• Deductible applies
G0103:
• Copayment/coinsurance waived
• Deductible waived
Screening Pelvic Examinations (includes a clinical breast examination)
HCPCS/CPT Codes
G0101 – Cervical or vaginal cancer screening; pelvic and clinical breast examination
ICD-10-CM Codes
High risk – Z77.22, Z77.9, Z91.89, Z72.89,
Z72.51, Z72.52, AND Z72.53
Low risk – Z01.411, Z01.419, Z12.4, Z12.72,
Z12.79, and Z12.89
Who Is Covered
All female Medicare beneficiaries
Frequency
• Annually if at high risk for developing cervical or vaginal cancer, or childbearing age with abnormal Pap test within past 3 years; or
• Every 2 years for women at normal risk
Beneficiary Pays
• Copayment/coinsurance waived
• Deductible waived
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CPT CODE G0102, G0103, G0101 - covered ICD 10 codes
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