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The CPT® Code 87185 refers to susceptibility studies that focus on the detection of enzymes produced by bacteria, specifically antimicrobial agents. This procedure is essential for determining the effectiveness of specific antibiotics against particular bacterial strains. The test is conducted in an agar solution, which serves as a medium for bacterial growth and interaction with the antibiotic. The primary aim of this study is to identify whether the bacteria produce enzymes, such as beta-lactamase, that can neutralize the effects of the antibiotic, thereby rendering it ineffective. This information is crucial for healthcare providers to select the appropriate antibiotic treatment for infections caused by resistant bacteria. The code is part of a broader set of susceptibility testing codes, each designated for different methodologies and purposes in evaluating bacterial resistance to antibiotics.
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The susceptibility study represented by CPT® Code 87185 is indicated for the following conditions:
The procedure for conducting susceptibility studies under CPT® Code 87185 involves several key steps:
Post-procedure care following the susceptibility study involves monitoring the patient for any adverse reactions to the antibiotics tested. The healthcare provider will review the results of the susceptibility testing to determine the most effective antibiotic therapy. It is essential to communicate the findings to the patient and adjust treatment plans accordingly. Additionally, follow-up testing may be necessary to ensure the effectiveness of the chosen antibiotic and to monitor for any potential development of further resistance.
| Short Descr | MICROBE SUSCEPTIBLE ENZYME | Medium Descr | SUSCEPTIBILITY STUDY ANTIMICROBIAL ENZYME DETCJ | Long Descr | Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme | 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 | 4 | CCS Clinical Classification | 206 - Microscopic examination (bacterial smear, culture, toxicology) |
| 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. | GW | Service not related to the hospice patient's terminal condition | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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. | 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 | 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 | 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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| 2011-01-01 | Changed | Short description changed. |
| 2001-01-01 | Added | First appearance in code book in 2001. |
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