Pathology/Lab Coding Alert

Question: When our lab performs a urine culture, how should we code if the culture is negative versus if we perform a presumptive identification? 


Illinois Subscriber


Answer: Most lab culture codes include both the isolation and a presumptive organism identification, such as 87070 (Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates).

Urine culture, however, has one code for the culture and a separate code for the presumptive identification of an isolate. The two codes are 87086 (Culture, bacterial; quantitative colony count, urine) and 87088 (... with isolation and presumptive identification of isolates, urine).

How it works: Many urine cultures are practically sterile or result in little colony growth. When this is the case, you should code only 87086 for the test.

But if the culture grows and the lab presumptively identifies an organism such as E. coli, you can report 87088 in addition to 87086. To bill both codes, you must have documentation of the presumptive identification.

There's more: Not only can you bill separately for a presumptive identification, you can bill for more than one. If the culture results in multiple colonies and the lab presumptively identifies each, you can report 87088 for each isolate.