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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.
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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:
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.
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 |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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