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The description for CPT code 87088 (Culture Urine with ID) has been changed from “presumptive identification of isolates, urine”, to “presumptive identification of each isolate, urine.” 1) Can CPT code 87088 now be used multiple times on a single urine culture? 2) Can both 87077 (definitive identification) and 87088 be used multiple times on a single urine culture? 3) Example: lactobacilli, diphtheroids, S.aureus, and E.coli are isolated on a urine culture. Would the coding be 87088 x2, 87077 x2, and 87086 (colony count on a urine culture)?
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Thanks for your interest in Askit. Microbiology CPT coding issues are complex. It is my experience that most hospitals have consultants who review and recommend CPT coding use. I suggest contacting your administration to see if such an expert is available to you.
Having said that, I think laboratories can bill for the identifion of potential pathogens. If spot tests are used to identify an E. coli, then 87088 would be used. If an instrument or kit identification is used, then 87077 would be appropriate. If a midstream urine contained two potential pathogens, two identification codes can be used. If a foley catheter urine (submitted if the patient is symptomatic) contains 3 potential pathogens, three identification codes can be used. The specific codes used would depend on the method of identification. In your example, since lactobacilli and diphtheroids are not potential pathogens, I would definitely not bill if you refer to them as "mixed flora." If you report them by name, check with a billing consultant used by your institution. Good luck!
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