Pathology/Lab Coding Alert

Question: How should we code the presumptive identification of anaerobic and aerobic organisms from blood cultures? CPT provides different microbiology codes for aerobic and anaerobic cultures, but the references to blood are confusing.


Colorado Subscriber

Answer: Although you could report two codes for an anaerobic and aerobic culture from other sources, you should just use one code for blood: 87040 (Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates [includes anaerobic culture, if appropriate]).

The other presumptive identification aerobic bacterial culture codes are:

• 87045--Culture, bacterial; stool, aerobic, with isolation and preliminary examination (e.g., KIA, LIA), Salmonella and Shigella species

• 87046--... stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate

• 87070--... any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates.

Unlike the blood culture code 87040, none of these definitions include the notation that the service includes the anaerobic culture. If the lab performs an anaerobic culture from these sources, you should use 87075 (Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates). Just to be sure you don't miss it, 87075 says, "except blood," so you should not report 87040 and 87075 together.

National Correct Coding Initiative edits confirm this coding restriction. Codes 87040 and 87075 represent an edit pair, while NCCI does not bundle 87045, 87046, or 87070 with 87075.