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The CPT® Code 87081 refers to a laboratory procedure known as a culture for presumptive pathogenic organisms, specifically designed for screening purposes only. This test is utilized when there is a suspicion of a specific pathogen causing an infection or disease. During the procedure, a blood sample is collected from the patient and subsequently placed in a specialized growth medium that is conducive to the proliferation of the suspected pathogen. The primary goal of this test is to identify the presence of pathogenic organisms by observing any colonies that may develop in the medium. If colonies are observed, they are then examined to determine the type of organism present. It is important to note that if the amount of pathogenic material in the colony is quantified using a reference chart, the appropriate code to report would be CPT® Code 87084. This distinction is crucial for accurate coding and billing, as it reflects the level of detail and specificity in the laboratory findings.
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The CPT® Code 87081 is indicated for use when there is a clinical suspicion of a specific pathogenic organism that may be responsible for an infection. This test is particularly relevant in cases where symptoms suggest the presence of a pathogen, and the healthcare provider seeks to confirm the diagnosis through laboratory testing. The screening nature of this procedure allows for the identification of potential infectious agents in patients presenting with various symptoms that may indicate an underlying infection.
The procedure for CPT® Code 87081 involves several key steps that ensure the accurate culture of presumptive pathogenic organisms. First, a healthcare professional collects a blood sample from the patient, which is critical for the subsequent analysis. This sample is then introduced into a growth medium that is specifically designed to support the growth of the suspected pathogen. The choice of medium is essential, as it must provide the necessary nutrients and environment conducive to the proliferation of the organism in question. After the blood sample is inoculated into the medium, it is incubated under controlled conditions to promote the growth of any potential pathogens. The incubation period allows for the development of colonies, which can then be observed and examined. If colonies are present, they are analyzed to identify the type of organism that has grown, aiding in the diagnosis of the suspected infection. Should the amount of pathogenic material in the colony be estimated using a reference chart, the appropriate coding would shift to CPT® Code 87084, reflecting a more detailed assessment of the culture results.
After the completion of the culture procedure associated with CPT® Code 87081, the laboratory will analyze the results based on the growth observed in the medium. If colonies are identified, further testing may be conducted to determine the specific type of pathogen and its susceptibility to various treatments. The results of this culture can guide the healthcare provider in making informed decisions regarding patient management and treatment options. It is essential for the healthcare provider to communicate the results to the patient and discuss any necessary follow-up actions or additional testing that may be required based on the findings. The recovery process for the patient typically does not involve any specific post-procedure care related to the culture itself, as it is a diagnostic test rather than a therapeutic intervention.
| Short Descr | CULTURE SCREEN ONLY | Medium Descr | CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ | Long Descr | Culture, presumptive, pathogenic organisms, screening only; | 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) |
| 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. | 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. | 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. | 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 | 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. | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GX | Notice of liability issued, voluntary under payer policy | 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 | LT | Left side (used to identify procedures performed on the left side of the body) | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | QW | Clia waived test | RT | Right side (used to identify procedures performed on the right side of the body) | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles |
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| 2010-01-01 | Changed | Code description changed. |
| 2001-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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