Pathology/Lab Coding Alert

Question: What code should we use for a culture "screening" test for Group B Streptococcus? If the test is positive and we go on to perform susceptibility testing, how should we code the additional work? Ohio Subscriber

Answer: When the lab screens a culture for Group B Streptococcus, you should code the service as 87081 (Culture, presumptive, pathogenic organisms, screening only). A culture screening is unique, because the lab is only testing the culture for the presence of one specific organism (positive: it's present, negative: it's not). In contrast, a typical culture involves isolating any organism present, then performing tests to identify it.

If the lab does isolate Group B Strep and goes on to perform sensitivity testing, you have several code choices depending on the lab method used.

For instance: Two common testing methods for determining bacterial susceptibility to antibiotics are the disk method or the minimal inhibitory concentration (MIC) method. If the lab performs a disk method for the susceptibility study, report 87184 (Susceptibility studies, antimicrobial agent; disk method, per plate [12 or fewer agents]). If you perform a MIC technique, use 87186 (... microdilution or agar dilution [minimum inhibitory concentration (MIC) or breakpoint], each multi-antimicrobial, per plate).

There are other susceptibility testing procedures that your lab might perform. They include susceptibility by antibiotic agar dilution (87181, ... agar dilution method, per agent [e.g., antibiotic gradient strip]) and macrobroth dilution (87188, ... macrobroth dilution method, each agent). There is also a code for susceptibility studies by enzyme detection (87185 ... enzyme detection [e.g., beta lactamase], per enzyme). You must know which method the lab uses before you can report the susceptibility studies appropriately.