Methicillin Resistant Staphylococcus aureus Culture Screen

Test Code
90417

CPT Codes
87081

Preferred Specimen

Swab of anterior nares - (see instructions)



Other Acceptable Specimens
Swab of anterior nares submitted in ESwab • Gram-positve cocci in clusters submitted in positive blood culture bottles • Swab submitted in sterile, plastic leak-proof container

Instructions
1. Use Amies' Liquid Transport Medium (Red-Cap Copan or BD swab, supply #3184), or Amies' Gel Transport Medium (Blue-Cap Copan or BD Swab, supply #132749), or ESwab (Copan, supply #15964) to obtain the specimen.
2. Culture both anterior nares (the opening of each nostril) using one culture swab.
3. Insert a premoistened swab (use sterile nonbacteriostatic saline or water) about 2 cm and rotate the swab against the nasal mucosa back and forth of each nostril for 3 seconds – slight pressure with a finger on the outside for the nose helps to assure good contact between the swab and the inside of the nose.
4. Return swab back to the plastic transport tube and make sure the cap is on tight.

For Skin Screen:
1. Use Liquid (red-cap), gel (blue-cap), or ESwab to obtain the specimen.
2. Rub premoistened swab against skin (i.e., axilla, perianal, and groin).
3. Return swab back to the plastic transport tube and make sure the cap is on tight.

Transport to laboratory for testing as soon as possible. Specimens must be received and processed in the laboratory within 48 hours of collection.
Indicate if patient is under antimicrobial therapy. Antimicrobial therapy initiated before the collection of specimens may result in a false negative culture.

Transport Container
Swab in Amies culture media, Eswab or equivalent

Transport Temperature
Room temperature

Specimen Stability
Room temperature: 48 hours
Refrigerated: 48 hours
Frozen: Unacceptable

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Received frozen • Specimens submitted in formalin • Specimens submitted in viral transport media • Dry swabs • Expired transport media • Specimens >48 hours old • Swabs from environmental sources

Methodology
Chrom Aagar method

Setup Schedule
Set up: Daily a.m. p.m. nights; Report available: Next day

Reference Range
No Methicillin Resistant Staphylococcus aureus (MRSA) isolated.

Clinical Significance
MRSA is a major cause of nosocomial and life threatening infections. Infections with MRSA have been associated with a significantly high morbidity, mortality and cost. Selection of these organisms has been greatest in the healthcare setting. However, MRSA has also become more prevalent in the community.
To control the transmission of MRSA, the Society for Healthcare Epidemiology of America (SHEA) has recommended guidelines, which include an active surveillance to identify potential reservoirs and a rigorous infection control program to control the spread of MRSA.
Rapid, accurate, and cost-effective screening tests for MRSA colonization are needed in order to reduce the economic burden of this pathogen.
The MRSA Culture Screen test detects colonization with Methicillin resistant Staphylococcus aureus (MRSA) in patients and can be used as a tool in infection prevention and control efforts. Early detection of this pathogen can accelerate the isolation process, thus minimizing the spread of infections.

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.