Pathology/Lab Coding Alert

Question: Because the lab always collects blood specimens as a set of two bottles and reports results for each -- the anaerobic bottle and the aerobic bottle -- should we report two CPT codes for two procedures?

Virginia Subscriber

Answer: No, you should only report one code for a blood culture to isolate organism(s) for suspected bacteremia. The correct code is 87040 (Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates [includes anaerobic culture, if appropriate]).

CPT does provide a separate code for anaerobic culture, and for any other source besides blood, you should report an additional code for an anerobic culture:87075 (... any source, except blood, anaerobic with isolation and presumptive identification of isolates).

Although 87040's and 87075's code definitions used to be ambiguous, the definitions now make it clear that a blood culture includes aerobic and anaerobic media if the lab uses both. Testing for aerobes and anaerobes is common for most blood culture protocols.

That's not all: Even though you shouldn't report an additional code for the initial anaerobic blood culture, you might need to report additional code(s) for work beyond presumptive identification.

If the lab isolates an organism and proceeds to definitively identify that bacteria, you should use one of the following codes to report the additional work, depending on the type of organism:

- 87076 -- Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate

- 87077 -- - aerobic isolate, additional methods required for definitive identification, each isolate.