ICD-10 Diagnosis Code R97.21

Rising PSA fol treatment for malignant neoplasm of prostate

Diagnosis Code R97.21

ICD-10: R97.21
Short Description: Rising PSA fol treatment for malignant neoplasm of prostate
Long Description: Rising PSA following treatment for malignant neoplasm of prostate
This is the 2019 version of the ICD-10-CM diagnosis code R97.21

Valid for Submission
The code R97.21 is valid for submission for HIPAA-covered transactions.

Code Classification
  • Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00–R99)
    • Abnormal tumor markers (R97)
      • Abnormal tumor markers (R97)


Version 2019 Billable Code Adult Diagnoses Diagnoses For Males Only Questionable Admission Codes

Information for Medical Professionals

According to ICD-10-CM guidelines this code should not to be used as a principal diagnosis code when a related definitive diagnosis has been established.


Code Edits
The following edits are applicable to this code:
Adult diagnoses - Adult. Age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).
Diagnoses for males only - Diagnoses for males only.
Questionable admission codes - Some diagnoses are not usually sufficient justification for admission to an acute care hospital. For example, if a patient is given code R030 for elevated blood pressure reading, without diagnosis of hypertension, then the patient would have a questionable admission, since elevated blood pressure reading is not normally sufficient justification for admission to a hospital.

Diagnostic Related Groups
The diagnosis code R97.21 is grouped in the following Diagnostic Related Group(s) (MS-DRG V35.0)

  • 947 - SIGNS AND SYMPTOMS WITH MCC
  • 948 - SIGNS AND SYMPTOMS WITHOUT MCC

Convert to ICD-9
  • 790.93 - Elvtd prstate spcf antgn (Approximate Flag)

Index to Diseases and Injuries
References found for the code R97.21 in the Index to Diseases and Injuries:


Replacement Code
This code replaces the following previously assigned ICD-10 code(s) listed below:
  • R97.2 - Elevated prostate specific antigen [PSA]


ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Present on Admission
The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.

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