Pathology/Lab Coding Alert

Question: A physician performed a rapid strep test in the office and sent out a throat swab for a strep screening culture. He also sent an ear discharge specimen for culture. Should we report this as 87070 x 2?

Missouri Subscriber

Answer: No, you should not report two units of 87070 (Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates) for these two tests.

Screening is different: You would report a strep screening culture as 87081 (Culture, presumptive, pathogenic organisms, screening only), because it is a test that screens for one particular organism. You would report the results of this test as positive or negative.

For the ear discharge culture, you are correct that you should report 87070. This is a different sort of test than 87081, because instead of screening for a particular organism, the ear culture could presumably isolate a variety of different organisms that the lab would then identify.

Medicare’s Correct Coding Initiative (CCI) edits used to bundle these two codes as a mutually exclusive code pair, but CMS later deleted the edit pair. Therefore, you should have no problem reporting 87081 and 87070 together for these two cultures.

Reader Questions and You Be the Coder were prepared with the assistance of R.M. Stainton Jr., MD, president of Doctors’ Anatomic Pathology Services in Jonesboro, Ark.