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The CPT® Code 87040 refers to a laboratory procedure known as a bacterial culture of blood, specifically designed to identify the presence of bacteria in a blood sample. In this procedure, a blood sample is collected from the patient and introduced into a culture medium that supports the growth of bacteria. This medium is specifically formulated to encourage the proliferation of aerobic bacteria, which require oxygen for growth. The process also includes the capability for anaerobic culture if deemed appropriate, allowing for the identification of bacteria that thrive in environments devoid of oxygen. Once the sample is incubated, any bacteria present will multiply, making them detectable. The subsequent isolation and presumptive identification of these bacterial isolates are crucial for diagnosing infections and determining appropriate treatment options. This procedure is essential in clinical settings for identifying bloodstream infections, which can be critical for patient management and care.
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The procedure associated with CPT® Code 87040 is indicated for the evaluation of suspected bloodstream infections. The following conditions may warrant the performance of this bacterial culture:
The procedure for CPT® Code 87040 involves several key steps to ensure accurate bacterial culture and identification:
After the completion of the bacterial culture procedure, the laboratory will analyze the results and report any findings. If bacterial growth is detected, the healthcare provider will receive information regarding the type of bacteria isolated, which is crucial for guiding treatment decisions. In cases where no growth is observed, it may indicate the absence of a bacterial infection, although further clinical correlation may be necessary. Patients may be monitored for any symptoms or signs of infection, and follow-up testing may be required based on the clinical scenario. Proper documentation of the procedure and results is essential for ongoing patient management and care.
| Short Descr | BLOOD CULTURE FOR BACTERIA | Medium Descr | CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES | Long Descr | Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1F - Lab tests - bacterial cultures | MUE | 2 | CCS Clinical Classification | 206 - Microscopic examination (bacterial smear, culture, toxicology) |
| 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | Q4 | Service for ordering/referring physician qualifies as a service exemption | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GW | Service not related to the hospice patient's terminal condition | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | RT | Right side (used to identify procedures performed on the right side of the body) | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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| 2004-01-01 | Changed | Code description changed. |
| 2001-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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