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R97.21

R97.21: Rising PSA following treatment for malignant neoplasm of prostate

Billable / specific codeICD-10-CM

R97.21 is a billable, specific ICD-10-CM code for rising psa following treatment for malignant neoplasm of prostate. It is valid for submission on a claim.

Check R97.21 with the rest of the claim: free scrubber

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

R97.21 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

  • A52480Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
  • A57427Billing and Coding: Transrectal Ultrasound

Alphabetic index entries that lead here

  • Rising, PSA following treatment for malignant neoplasm of prostate

Code history

Unchanged in every release from FY2024 to FY2027.

Other codes under R97.2

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.