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Official Description

Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 87205 refers to a laboratory procedure known as a smear, which is performed on a primary source with interpretation. This procedure utilizes either Gram or Giemsa staining techniques to identify the presence of bacteria, fungi, or specific cell types within samples such as pus, normally sterile body fluids, or aspirated materials. The Gram stain is a differential staining method that categorizes bacteria into two main groups: gram-positive (Gram+) and gram-negative (Gram-). Gram+ bacteria are characterized by a thick peptidoglycan layer in their cell walls, which results in a purple coloration when stained. On the other hand, the Giemsa stain is primarily used in cytogenetics for chromosome analysis and in histopathology to identify various pathogens, including trichomonas, spirochetes, protozoans, and malaria, as well as to differentiate between various cell types in blood and bone marrow samples. During the procedure, a small drop of the suspended culture or cell material is spread in a thin layer on a microscope slide using an inoculation hook, followed by heat fixation. The slide is then stained, and a detailed examination is conducted under a microscope to identify and count the bacteria, fungi, or cells present. The findings are compiled into a written report, providing essential information for diagnosis and treatment planning.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 87205 is indicated for the identification of various microorganisms and cell types in clinical specimens. The following conditions or situations may warrant the performance of this test:

  • Identification of Infections This test is performed to detect the presence of bacterial or fungal infections in samples such as pus or other normally sterile body fluids.
  • Diagnosis of Parasitic Infections The Giemsa stain is utilized to identify specific parasites, including trichomonas and malaria, in clinical specimens.
  • Cell Type Differentiation The procedure aids in differentiating various cell types in blood and bone marrow, which is crucial for diagnosing hematological conditions.

2. Procedure

The procedure for CPT® Code 87205 involves several key steps that ensure accurate identification of microorganisms and cell types. The following outlines the procedural steps:

  • Step 1: Sample Collection A sample is collected from the patient, which may include pus, normally sterile body fluids, or aspirated material. This sample serves as the primary source for the smear.
  • Step 2: Slide Preparation A drop of the collected sample is placed on a microscope slide. Using an inoculation hook, the sample is spread in a thin layer across the slide to create an even smear.
  • Step 3: Heat Fixation The slide is subjected to heat fixation, which involves passing it through a flame. This step is crucial as it adheres the sample to the slide and kills any live microorganisms, preserving the sample for staining.
  • Step 4: Staining The prepared slide is stained using either the Gram or Giemsa staining technique. The choice of stain depends on the specific microorganisms or cell types being investigated.
  • Step 5: Microscopic Examination After staining, the slide is examined under a microscope. The technician identifies and counts the bacteria, fungi, or cells present in the sample.
  • Step 6: Reporting Findings A written report is generated, detailing the findings from the microscopic examination, including the types and quantities of microorganisms or cells identified.

3. Post-Procedure

Post-procedure care for CPT® Code 87205 typically involves the proper disposal of the used slides and any remaining samples, following standard laboratory safety protocols. There are no specific recovery considerations for patients, as this procedure is performed in a laboratory setting and does not involve any invasive techniques. The results of the test are usually communicated to the requesting physician, who will interpret the findings in the context of the patient's clinical condition and determine any necessary follow-up actions or treatments based on the report.

Short Descr SMEAR GRAM STAIN
Medium Descr SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL
Long Descr Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types
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.
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.
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.
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.
GW Service not related to the hospice patient's terminal condition
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
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.
Q4 Service for ordering/referring physician qualifies as a service exemption
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
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AY Item or service furnished to an esrd patient that is not for the treatment of esrd
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
GZ Item or service expected to be denied as not reasonable and necessary
LT Left side (used to identify procedures performed on the left side of the body)
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
PN Non-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)
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
2011-01-01 Changed Short description changed.
2001-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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