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Official Description

Culture, mycobacterial, definitive identification, each isolate

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A laboratory test known as culture for mycobacterial definitive identification is performed to isolate and accurately identify mycobacteria from various body fluid samples. Mycobacteria are a group of bacteria that are characterized as aerobic, non-motile, and acid-fast bacilli, which means they retain certain stains even after being washed with acid. This unique property is due to their thick, waxy, and hydrophobic cell wall, which poses challenges in both culturing the bacteria and treating infections caused by them. The procedure involves collecting fluid samples from different sources, including cerebrospinal fluid, gastric aspirate, respiratory secretions, bronchial washings or brushings, sputum, urine, or corneal wash. These samples are collected through separately reported procedures. Once collected, the fluid samples are placed in a specialized culture medium that supports the growth of mycobacteria. The culture is then incubated for a specified duration to allow the bacteria to proliferate. After sufficient growth, the cells are analyzed using advanced techniques such as Matrix Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) mass spectrometry, which enables the definitive identification of specific mycobacterial species, including M. tuberculosis complex, M. avium complex, M. kansasii, and M. gordonae.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The culture for mycobacterial definitive identification is indicated for the diagnosis of infections caused by mycobacteria. This procedure is particularly relevant in the following scenarios:

  • Suspected Tuberculosis - When a patient presents with symptoms suggestive of tuberculosis, such as persistent cough, weight loss, fever, and night sweats, this test is crucial for confirming the presence of M. tuberculosis.
  • Non-Tuberculous Mycobacterial Infections - In cases where patients exhibit symptoms of infections caused by non-tuberculous mycobacteria, such as M. avium complex or M. kansasii, this culture helps in identifying the specific organism responsible for the infection.
  • Monitoring Treatment Efficacy - This procedure may also be indicated for monitoring the effectiveness of treatment in patients already diagnosed with mycobacterial infections, ensuring that the chosen therapy is effective against the identified strain.

2. Procedure

The procedure for mycobacterial culture and definitive identification involves several critical steps to ensure accurate results. Each step is designed to facilitate the growth and identification of mycobacteria from the collected samples.

  • Sample Collection - The first step involves the collection of body fluid samples from the patient. This can include cerebrospinal fluid, gastric aspirate, respiratory secretions, bronchial washings or brushings, sputum, urine, or corneal wash. Each of these samples is collected through a separate procedure, ensuring that the sample is suitable for culturing mycobacteria.
  • Inoculation of Culture Medium - Once the samples are collected, they are inoculated into a specialized culture medium that is conducive to the growth of mycobacteria. This medium is designed to support the unique growth requirements of these bacteria, which are often slow-growing and require specific conditions.
  • Incubation - The inoculated culture medium is then incubated for a specified period, allowing the mycobacteria to grow. This incubation period can vary depending on the type of mycobacteria being cultured, as some species may take longer to proliferate.
  • Identification of Mycobacteria - After the incubation period, the culture is examined using Matrix Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) mass spectrometry. This advanced technique allows for the precise identification of the mycobacterial species present in the culture, including M. tuberculosis complex, M. avium complex, M. kansasii, and M. gordonae.

3. Post-Procedure

After the completion of the mycobacterial culture and identification procedure, the laboratory will provide a report detailing the findings. This report will include the specific mycobacterial species identified, which is crucial for guiding treatment decisions. Depending on the results, further clinical management may be required, including the initiation or adjustment of antibiotic therapy. It is important for healthcare providers to discuss the results with the patient and consider any necessary follow-up testing or monitoring to ensure effective treatment of the identified mycobacterial infection.

Short Descr MYCOBACTERIC IDENTIFICATION
Medium Descr CULTURE MYCOBACTERIAL DEFINITIVE ID EA ISOL
Long Descr Culture, mycobacterial, definitive identification, each isolate
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 3
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.
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.
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.
GW Service not related to the hospice patient's terminal condition
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
Date
Action
Notes
2001-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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