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The CPT® Code 87109 refers to a laboratory test specifically designed to culture mycoplasma from any source. Mycoplasma are unique microorganisms characterized as the smallest of free-living organisms, notable for their lack of a cell wall, which allows them to replicate independently without the need for a host. Among the various species of mycoplasma, two of the most prevalent are M. pneumoniae and M. hominis. The former is associated with atypical pneumonia and can lead to mild upper respiratory infections, including tracheobronchitis, as well as ocular infections such as conjunctivitis and iritis. In more severe cases, M. pneumoniae can result in complications like swelling of the optic disc, optic nerve atrophy, and retinal exudate or hemorrhaging. On the other hand, M. hominis is primarily linked to infections of the adult urogenital tract and can also cause respiratory infections in neonates. To perform the culture, an appropriate fluid or tissue sample must first be collected. This can include a variety of fluid samples such as ocular fluid, respiratory secretions (e.g., throat or nasopharyngeal swab/aspirate, bronchial lavage washings), pleural fluid, pericardial fluid, synovial fluid, amniotic fluid, cerebrospinal fluid, urine, and swabs from vaginal, cervical, urethral, or prostatic sources. Tissue samples may be obtained from sites such as the lung, placenta, endometrium, fallopian tube, bone, or urinary calculi. Once the sample is collected, it is placed in a suitable culture medium and incubated for several days to allow for the growth of mycoplasma. Following the incubation period, the cells are examined microscopically to identify the presence of the mycoplasma organism, confirming the diagnosis and guiding further clinical management.
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The culture for mycoplasma is indicated in various clinical scenarios where infection by these organisms is suspected. The following conditions may warrant this laboratory test:
The procedure for culturing mycoplasma involves several critical steps to ensure accurate identification of the organism. First, an appropriate fluid or tissue sample must be collected from the patient. This can include a variety of sources such as ocular fluid, respiratory secretions (e.g., throat or nasopharyngeal swab/aspirate, bronchial lavage washings), pleural fluid, pericardial fluid, synovial fluid, amniotic fluid, cerebrospinal fluid, urine, or swabs from vaginal, cervical, urethral, or prostatic areas. In some cases, tissue samples may be obtained from the lung, placenta, endometrium, fallopian tube, bone, or urinary calculi. Once the sample is collected, it is placed in a specialized culture medium that supports the growth of mycoplasma. The sample is then incubated for a specified period, typically several days, to allow the mycoplasma organisms to proliferate. During this incubation phase, conditions such as temperature and humidity are carefully controlled to optimize growth. After the incubation period, the culture is examined under a microscope to identify the presence of mycoplasma organisms. This microscopic examination is crucial for confirming the diagnosis and determining the appropriate clinical management for the patient.
After the culture procedure, the laboratory will monitor the growth of mycoplasma over the incubation period. Once the results are available, they will be communicated to the healthcare provider, who will interpret the findings in the context of the patient's clinical presentation. Depending on the results, further diagnostic testing or treatment may be necessary. It is important for healthcare providers to consider the possibility of false negatives, as mycoplasma can be challenging to culture and may require specific conditions for growth. Patients may not require any specific post-procedure care, but they should be informed about the potential for follow-up based on the culture results.
| Short Descr | MYCOPLASMA | Medium Descr | CULTURE MYCOPLASMA ANY SOURCE | Long Descr | Culture, mycoplasma, any source | 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) | T1H - Lab tests - other (non-Medicare fee schedule) | 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. | GW | Service not related to the hospice patient's terminal condition | 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. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | 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 |
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