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Charging for Microbiology

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Hello, I am doing some research of the following questions and was wondering if someone can help assist me.

Microbiology Charging

1. We perform MRSA and MRSA/MSSA cultures that utilize a special media that we can identify bacteria to the Genius Species level by visual interpretation. This media contains antibiotics and biochemical that are specific for these organisms. Many of these cultures we do not do any supplemental testing to report an identification. Can we charge for an aerobic identification in these circumstances if we are not performing any supplemental testing for identification? We would charge the CPT code: 87077 aerobic identification.

2. We have a test that we would like to only report the interpretation of the test not the actual components as this is leading to confusion for the clinician. Currently, we charge for those two components. Could we still charge for those two components but not have those results viewable by the clinician? The components would be resulted internally to where only the laboratory would be able to view the results. We would only report the interpretation of those two results.

3. We perform a stool cultures that only look for certain bacteria. We perform several rule out identifications for each culture. Is it appropriate to charge an aerobic identification to rule out a possible pathogen that is part of the Stool Culture screen? We are performing the work and it is part of our Policy/Procedure to set up these "rule out" identifications but many times we report out these cultures as Negative for Salmonella, Shigella, Campy, etc.

3. For urine cultures there are is a CPT code: 87088 urine aerobic ID that can be used for charging an identification. We also have CPT code: 87077 aerobic identification. We perform the same method of testing for both CPT charges. Can we just charge the one CPT code: 87077 aerobic identification and not charge the CPT code: 87088 urine aerobic identification? From what I have been told in the past, the urine aerobic ID was really developed for "presumptive identification", which meant visual and 2 other biochemical tests that are only appropriate for urine specimens only. I am not for sure if there is any truth to that or not. I would like to charge the CPT 87077 aerobic identification for these as this would be consistent with other culture types.
 
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