Mycobacteria, Culture, with Fluorochrome Smear [4554X]

Test Code
5202

CPT Codes
87015, 87116, 87206

Includes
Mycobacteria Culture; Concentration; Acid-Fast Bacilli Stain

An additional charge for Concentration (CPT code(s): 87015) will be added as appropriate.

Identification will be performed at an additional charge for each organism
CPT code(s) 87149: M. tuberculosis Complex Probe or
CPT code(s) 87149: M. avium Complex Probe or
CPT code(s) 87149: M. kansasii Probe or
CPT code(s) 87149: M. gordonae Probe

If the organism cannot be identified by the original method additional bill only charges may be added
CPT code(s) 87118: Matrix Assisted Laser Desorption/Ionization-Time of Flight (1, 2 & 3) or
CPT code(s) 87153: AFB Sequencing (1, 2 & 3)

If TB is isolated for the first time or after three months after the first isolate from a patient, susceptibilities will be performed at an additional charge (CPT code(s): 87190 per drug.

Preferred Specimen
10 mL body fluids or lower respiratory tract specimens or gastric lavage,or
Minimum: 2 mL CSF, or
2 grams fresh (unfixed) tissue, or
50 mL urine collected in a sterile, leak-proof container, or
Minimum: 1 mL or 1 swab wound, exudates, aspirates, lesion material, ocular specimens collected in a sterile, leak-proof container or Amies liquid, Amies gel swab transport system, Stuarts or ESwab

Patient Preparation
Expectorated sputum: Instruct patient to gargle with water and cough deeply. Three separate early morning collections on at least three consecutive days are recommended.

Minimum Volume
2 mL body fluid, lower respiratory tract specimens
5 mL gastric lavage
1 gram fresh (unfixed) tissue
40 mL urine

Other Acceptable Specimens
10 grams of stool collected in a sterile, leak-proof container

Instructions
Tissue and biopsy material: Sterile leak-proof container with small amount of saline, no fixative or preservative.
Gastric lavage fluid: Sterile leak-proof container. Must be neutralized with sodium bicarbonate within 4 hours of collection.

Transport Temperature
Refrigerated (cold packs)

Specimen Stability
Room temperature: Unacceptable
Refrigerated: 5 days
Frozen: Unacceptable

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Specimen in formalin or alcohol • Leaked specimen • 24-hour sputum or urine • Urine in preservative

Methodology
Continuous Monitoring Broth Culture System and Conventional Culture • Microscopic Exam with Fluorochrome Stain

Setup Schedule
Set up: Daily; Report available: 49 days

Reference Range
See Laboratory Report

Clinical Significance
There are more than 70 species of mycobacteria of which the primary pathogen is M. tuberculosis. Tuberculosis is a chronic, granulomatous disease caused by M. tuberculosis. Identification, and, if appropriate, antibiotic sensitivity, is required to initiate necessary therapy.

Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153




The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.