Pathology/Lab Coding Alert
Focus on C. difficile Test Method
Question: The physician ordered a Clostridium difficile test for a patient exhibiting watery diarrhea, fever, and abdominal cramps but a negative EIA finding. We performed the amplified probe test. How should we code this?
Texas Subscriber
Answer: The correct code for an amplified probe test for Clostridium difficile is 87493 (Infectious agent detection by nucleic acid [DNA or RNA]; Clostridium difficile, toxin gene[s], amplified probe technique).
Physicians often order the enzyme immunoassay (EIA) test for the C. difficile toxins A and B on a stool specimen as the initial test (87324, Infectious agent antigen detection by immunoassay technique [eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA], qualitative or semiquantitative, multiple-step method; Clostridium difficile toxin[s]). The toxin(s) are the focus of the text because non-toxin producing strains of C. difficile are not pathogenic.
Because the nucleic acid probe test is more sensitive than the EIA test, physicians may order the test following a negative EIA test if clinical suspicion of C. difficile is still high.
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