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Pathology/Lab Coding Alert

Reader Question:

Susceptibility Rule: Choose 1

Published on Tue Sep 01, 2009

Question: We perform a susceptibility test for staphylococcus isolates using a Vitek analyzer. Because one of the isolates tests Penicillin sensitive while most are Penicillin resistant, we also had to perform an induced beta lactamase test. Can we code the beta lactamase enzyme detection (87185) in addition to the original susceptibility study? New York Subscriber Answer: No, for a single isolate, you should not report 87185 in addition to the code for the original susceptibility test. Doing so goes against both CPT coding principles and Correct Coding Initiative (CCI) edits. CPT provides a family of codes for susceptibility studies as follows, based on the lab method: • 87181 -- Susceptibility studies, antimicrobial agent; agar dilution method, per agent (e.g., antibiotic gradient strip) • 87184 -- ... disk method, per plate (12 or fewer agents) • 87185 -- ... enzyme detection (e.g., beta lactamase), per enzyme • 87186 -- ... microdilution or agar dilution (minimum [...]
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