4Kscore

Alphabetical Test listing

4Kscore-994

Test name:

4Kscore

Test number:

994

Excellian order number:

LAB994

Abbreviation:

MSO

Alternate names:

Prostate-specific kallikrein

Tests included:

4 Kallikrein biomarkers:

Total PSA
Free PSA
Percent free PSA
Intact PSA
hK2

Useful for:

Stratifies risk of aggressive prostate cancer in patients with elevated PSA for whom biopsy is being considered.

Limitations:

Test should not be ordered if:

Prostate cancer was previously diagnosed
Digital rectal exam was performed within the last 4 days
Any procedure or therapy was used to treat symptomatic benign prostatic hyperplasia (BPH) within the past 6 months
Any invasive urologic procedure that may be associated with a secondary PSA evaluation was done within the past 6 months
5-alpha reductase inhibitor (5-ARI) therapy, such as Avodart (dutasteride) or Proscar (finasteride), was administered within the past 6 months.

Patient preparation information:

Test intended for patients 40 years of age or older.

Specimen type:

Serum

Collection container:

Gold serum separator (SST) tube x 2

Volume:

4.0 mL

Minimum volume:

3.0 mL

Collection instructions:

Immediately following collection, mix sample by gently inverting 5 times

Processing instructions:

Allow sample to clot for a minimum of 30 minutes
Spin within two (2) hours of sample collection
Transfer serum to a Screw-cap polypropylene frozen transport vial/tube - 4mL (LabCorp)
Freeze

Transport container:

Screw-cap polypropylene frozen transport vial/tube - 4mL (LabCorp)

Transport and stability:

Frozen (preferred) - 1 month

Refrigerated - 72 hours

Ambient - NO

Reason for rejection:

Specimen received in a frozen gel separator (SST) tube

Performing lab:

ARUP (2014059) via LabCorp (009985): R-NX

Days set up:

Varies

TAT:

7 days

Method:

Electrochemiluminescence Immunoassay (ECLIA)

Reference ranges:

See report

CPT codes:

81539

Subject to medical necessity (Y/N):

Yes

Other billing information:

Medical necessity

Hospital clients submitting a request for this assay on an outpatient with Medicare should complete and submit a Molecular Medical billing request form along with the sample.

Complete and submit the form to notify us of the need for Allina Health Laboratory to bill insurance for Molecular testing performed
All information requested is required in order for your request to be completed

Molecular Medicare billing request

Date created:

06/28/2022

Review date:

06/28/2022