Pathology/Lab Coding Alert

Question: A physician orders a direct sputum acid-fast stain and culture for mycobacteria for a patient with cystic fibrosis showing pulmonary exacerbation. Which  diagnosis and procedure codes should we report?

New York Subscriber Answer: You should report the cystic fibrosis diagnosis to the fifth digit. Because the ordering physician stated, "pulmonary exacerbation," the narrative description points to a diagnosis of 277.02 (Cystic fibrosis; with pulmonary manifestations).

The physician ordered two tests -- an acid-fast bacillus stain on a direct sputum smear, and a sputum culture for mycobacteria. Code the two procedures as follows:

87206 - Smear, primary source with interpretation; fluorescent and/or acid-fast stain for bacteria, fungi, parasites, viruses or cell types
87116 - Culture, tubercle or other acid-fast bacilli (e.g., TB, AFG, mycobacteria) any source, with isolation and presumptive identification of isolates.