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The CPT® Code 87190 refers to susceptibility studies specifically designed to evaluate the effectiveness of antimicrobial agents against mycobacteria, which are a type of bacteria that includes pathogens such as those responsible for tuberculosis. This procedure employs the proportion method, a laboratory technique that assesses how well various antibiotics can inhibit the growth of mycobacteria. The test is conducted in an agar solution, which serves as a growth medium for the bacteria. By determining the susceptibility of mycobacteria to specific antibiotics, healthcare providers can make informed decisions regarding the most effective treatment options for infections caused by these organisms. This code is particularly relevant in the context of antibiotic resistance, as it helps identify which antibiotics remain effective against resistant strains of mycobacteria. It is important to note that other related codes exist for different testing methods and types of bacteria, each serving a unique purpose in the assessment of antimicrobial susceptibility.
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The susceptibility studies indicated by CPT® Code 87190 are performed to determine the effectiveness of specific antimicrobial agents against mycobacteria. The following conditions may warrant this testing:
The procedure for conducting susceptibility studies using CPT® Code 87190 involves several key steps, which are detailed below:
After the susceptibility study is completed, the results are compiled and analyzed. Healthcare providers will review the findings to determine the most effective antibiotic treatment for the patient. It is essential to communicate these results promptly to ensure timely adjustments to the patient's treatment plan. Additionally, follow-up testing may be necessary to monitor the patient's response to the prescribed antibiotics and to check for any potential development of resistance during treatment. Proper documentation of the results and any subsequent treatment decisions is crucial for ongoing patient care and compliance with medical standards.
| Short Descr | MICROBE SUSCEPT MYCOBACTERI | Medium Descr | SUSCEPTIBLTY STDY ANTMCRB MYCOBACT PROPORJ MTHD | Long Descr | Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent | 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 | 9 | 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. | 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. | 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. | GZ | Item or service expected to be denied as not reasonable and necessary | 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 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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