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Official Description

Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 87230 refers to a laboratory procedure known as a toxin or antitoxin assay performed using tissue culture methods. This assay is specifically designed to detect the presence of toxins produced by certain organisms, such as Clostridium difficile, which is a bacterium that can cause severe gastrointestinal issues. In this procedure, a stool sample is collected from the patient, which serves as the specimen for testing. The primary goal of this assay is to identify whether the stool contains toxins that indicate an infection or other pathological conditions related to the organism. The use of tissue culture in this context allows for a more accurate assessment of the presence of these harmful substances, thereby aiding in the diagnosis and management of infections associated with toxin-producing bacteria.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The toxin or antitoxin assay, as indicated by CPT® Code 87230, is performed under specific circumstances where there is a clinical suspicion of infections caused by toxin-producing organisms. The following conditions may warrant this procedure:

  • Clostridium difficile infection The assay is indicated when a patient presents with symptoms such as diarrhea, abdominal pain, and fever, which may suggest an infection caused by Clostridium difficile.
  • Gastrointestinal symptoms Patients exhibiting gastrointestinal symptoms that are unexplained or severe may require testing to rule out the presence of toxins in the stool.
  • Post-antibiotic treatment The procedure may be indicated in patients who have recently undergone antibiotic therapy and are experiencing recurrent gastrointestinal symptoms, as antibiotics can disrupt normal gut flora and allow for the overgrowth of toxin-producing bacteria.

2. Procedure

The procedure for conducting a toxin or antitoxin assay using tissue culture involves several critical steps to ensure accurate results. Each step is essential for the proper collection, handling, and analysis of the stool sample.

  • Step 1: Sample Collection A stool sample is collected from the patient, ensuring that it is obtained in a sterile manner to prevent contamination. The sample should be collected as soon as possible after the onset of symptoms to increase the likelihood of detecting toxins.
  • Step 2: Sample Preparation The collected stool sample is then prepared for analysis. This may involve mixing the sample with specific culture media that supports the growth of Clostridium difficile and allows for the detection of toxins produced by the organism.
  • Step 3: Incubation The prepared sample is incubated under controlled conditions that promote the growth of the bacteria. This step is crucial as it allows for the production of toxins if the organism is present in the sample.
  • Step 4: Toxin Detection After the incubation period, the culture is examined for the presence of toxins. Various assays may be employed to confirm the presence of Clostridium difficile toxins, including immunoassays or molecular techniques.
  • Step 5: Result Interpretation The results of the assay are interpreted by laboratory personnel, who will determine whether the toxins are present and report the findings to the requesting physician for further clinical decision-making.

3. Post-Procedure

After the toxin or antitoxin assay is completed, the laboratory will provide a report detailing the presence or absence of toxins in the stool sample. If toxins are detected, the physician may consider initiating or adjusting treatment for the patient, which could include antibiotics or other therapeutic measures. It is important for healthcare providers to discuss the results with the patient and consider any necessary follow-up care or additional testing based on the findings. Patients may also be advised on dietary modifications or other supportive measures to manage symptoms associated with the infection.

Short Descr ASSAY TOXIN OR ANTITOXIN
Medium Descr TOXIN/ANTITOXIN ASSAY TISSUE CULTURE
Long Descr Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin)
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.
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
GW Service not related to the hospice patient's terminal condition
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
Date
Action
Notes
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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