Ordering Recommendation

Test intended for patients 40 years of age or older. Stratifies risk of aggressive prostate cancer in patients with elevated PSA for whom biopsy is being considered. Test should not be ordered if (1) prostate cancer was previously diagnosed; (2) digital rectal exam was performed within the last 4 days; (3) any procedure or therapy was used to treat symptomatic benign prostatic hyperplasia (BPH) within the past 6 months; (4) any invasive, urologic procedure that may be associated with a secondary PSA evaluation was done within the past 6 months; (5) 5-alpha reductase inhibitor (5-ARI) therapy, such as Avodart (dutasteride) or Proscar (finasteride), was administered within the past 6 months.




Electrochemiluminescent Immunoassay




3-6 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation

Serum Separator Tube (SST).

Specimen Preparation

Transfer 4 mL serum to an ARUP Standard Transport Tube. (Min: 3 mL)
Test is not performed at ARUP; separate specimens must be submitted when multiple tests are ordered.

Storage/Transport Temperature


Unacceptable Conditions

Frozen Serum Separator Tubes (SST).


Biopsy history must be provided at time of order.


Ambient: Unacceptable; Refrigerated: 72 hours; Frozen: 1 month

Reference Interval

By report

Interpretive Data

Compliance Category

Performed by non-ARUP Laboratory


4 Kallikrein Biomarkers: Total PSA, Free PSA, percent free PSA, Intact PSA and hK2. Test should not be ordered if Digital Rectal Exam (DRE) has been performed within the last 4 days or if biopsy history is positive.

Hotline History


CPT Codes



Component Test Code* Component Chart Name LOINC
2014060 4K - Biopsy History 66117-3
2014061 4K - Digital Rectal Exam (DRE) 10205-3
2014063 4K - Score 19146-0
2014309 4K - PSA, Total 83112-3
2014310 4K - PSA, Free 83113-1
2014311 4K - PSA, Percent Free 12841-3
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.


  • 4K Prostate Screen; Prostate test
  • Kallikrein score
Prostate-Specific Kallikrein, 4Kscore

BioReference Laboratories