Culture, Sputum with Gram Stain

Test Code

C SP - MM MMC

CPT Codes
87070, 87205, 87077 per organism (if appropriate), 87186 per organism (if appropriate)

Preferred Specimen

Expectorated Sputum, Induced Sputum, Tracheal Aspirate

Instructions

Expectorated Sputum

Aseptically collect 1 mL of sputum in a screw-capped, sterile container.
The specimen should be a single, first-morning, deep-cough sputum specimen, and the patient should not have eaten prior to collection. When antibiotics are to be started immediately, a first-morning specimen is still preferred.
Instruct patient to brush his/her teeth and/or rinse mouth well with water. Have patient remove dentures.
Instruct the patient to take a deep breath, hold it momentarily, and cough deeply and vigorously into the container. Close lid securely.
If the patient is unable to produce sputum, induction may requested.
Label container (not the lid) with two patient identifiers (full name, DOB or MR), specimen source, and date and time of collection.
Maintain sterility and forward promptly..
- Note: If the quality of the expectorated sputum (Q value) specimen is not good, the specimen will be rejected. The quality of specimen is based on the number of WBCs vs. epithelial cells. The greater number of WBCs the better quality of specimen. A positive Q value (1+, 2+, 3+) is better quality and will be cultured. This is also an indicator that the specimen is from the infected area.

Induced Expectoration.

Specimen will be collected aseptically by respiratory therapy personnel.
Label container (not the lid) with two patient identifiers (full name, DOB or MR), specimen source, and date and time of collection.
Maintain sterility and forward promptly.
- Note: Includes culture regardless of specimen quality.

Tracheal Aspirate.

2 mL to 5 mL of aspirate specimen collected by a physician using sterile technique.
Submit specimen in a screw-capped, sterile container.
Label container (not the lid) with two patient identifiers (full name, DOB or MR), specimen source, and date and time of collection.
Maintain sterility and forward promptly.
- Note: Tracheal aspirates will be screened for culture and rejected if any of the following occurs: No organisms observed on the Gram stain. If >10 squamous epithelial cells per low-power field. Finding only yeast on the Gram stain.

Specimen must arrive within 1 hour of collection.
If there is a delay in transport of >1 hour of collection, keep specimen refrigerated.

Transport Temperature

Refrigerate

Specimen Stability

Specimen Type	Temperature	Time
Sputum or Tracheal Aspirate	Ambient	2 hours
Sputum or Tracheal Aspirate	Refrigerate	24 hours

Methodology
Conventional Culture Media
Note: Every organism identified by a commercial kit must be billed for bacterial identification. Any organism that requires susceptibility testing will be charged for a minimal inhibitory concentration (MIC).

Setup Schedule

Monday through Sunday; Continuously

Report Available

2 - 3 days

Reference Range

Usual flora may be present at 2 days.

Performing Laboratory
McKee Medical Center - Microbiology/Molecular Laboratory

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.