Pathology/Lab Coding Alert

Question: Our lab identified Proteus rettgeri from a wound culture, and performed susceptibility testing by the MIC method using a Vitek-2 autoanalyzer. How should we code the service? Idaho Subscriber Answer: Whether you use a microbiology analyzer such as the Vitek 2 that combines several steps, or more traditional microbiology methods, you should report each step that your lab performs for a given culture. You might have a code for one or more of the following steps: - culture and presumptive identification (first step for most cultures) - definitive identification (to the species level) - culture typing (such as different strains of a species) - susceptibility studies. Although the Vitek 2 can combine the definitive identification and minimum inhibitory concentration (MIC) steps on a single plate, you should still code each billable step of the combined analysis. In your example, the correct codes are as follows: - 87070 -- Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates - 87077-- Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate - 87186 -- Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [MIC] or breakpoint), each multi-antimicrobial, per plate. Caution: Make sure you select billable codes based on the guidelines for additional studies at the beginning of the CPT microbiology section just before 87001.