4Kscore Test Algorithm

The 4Kscore test is covered when the true 4Kscore algorithm (four kallikrein proteins plus age, DRE result, and prior biopsy history) is present and used in men aged ≥45 who are being considered for initial prostate biopsy or after a negative biopsy with a confirmed moderately elevated PSA (3–10 ng/mL; 4–10 ng/mL if >75 years). Coverage requires documented shared decision making and PSA verification under standardized conditions; tests missing any required component or lacking shared decision documentation are not covered.

"All components of the 4Kscore algorithm must be present: four kallikrein protein measurements (total PSA, free PSA, intact PSA, hK2) plus clinical information (age, digital rectal examination resul..."

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