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prostate specific antigen, free
Synonyms: Free PSA 
Computer Code: FPSA
Specimen Collection: 3 mL whole blood (gold top preferred, red top acceptable). 
Minimum Volume: 3 mL 
Handling Instructions for Offsite Areas: Allow to clot, centrifuge for 20 minutes, refrigerate. Serum must be removed from red top tube. Centrifuge and refrigerate within 3 hours of blood draw. 
Reference Values: Free PSA can not be ordered as an individual test. The PSA Differential must be performed for complete interpretation. See Addendum VI for interpretation. See Addendum VI  
Lab Code: SI 
Requisition: SEROL
Test Frequency: Weekly 
Routine TAT: 3-4 days 
Stat TAT: NA 
CPT Code(s): 84154 
LCD or NCD: (NCD) http://www.cms.hhs.gov/mcd/index_section.asp?ncd_sections=40 
Methodology Used: 77
See Addendum XVII

Albany Medical Center
43 New Scotland Avenue
Albany, NY, 12208
Date: 05/24/2016
Time: 23:27:40 (24hr)