Pathology/Lab Coding Alert

Question: When a physician orders blood culture for suspected bacteremia, the lab performs both an anaerobic and an aerobic culture. Should we report two separate codes because we perform two cultures?

South Carolina Subscriber Answer: Although you would report aerobic and anaerobic cultures separately from most sources, blood is the exception. The correct code for bacterial blood culture is 87040 (Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates [includes anaerobic culture, if appropriate]).

Because CPT has a separate code for anaerobic culture, there had been some confusion about whether to separately report anaerobic blood cultures. But modified definitions in CPT Codes 2004 clarified correct blood-culture coding. Code 87040 specifies "aerobic" and also states that it "includes anaerobic culture," so the code clearly describes presumptive identification of either type of organism and includes both cultures.

A change to the anaerobic culture code also clarifies blood coding: 87075 (Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates) prohibits using the code for blood. Before the 2004 change, 87040 specified any source and did not include the phrase "except blood."

Some coders had been reporting 87040 and 87075 together for aerobic and anaerobic blood cultures. The 2004 CPT definition changes should end this incorrect coding practice.