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Mycobacteria, Culture, with Fluorochrome Smear
Test Code4554
CPT Codes
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) 87118: Matrix Assisted Laser Desorption/Ionization-Time of Flight or
CPT code(s) 87153: AFB Sequencing
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.
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) 87118: Matrix Assisted Laser Desorption/Ionization-Time of Flight or
CPT code(s) 87153: AFB Sequencing
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 collected in a sterile leak-proof container or
2 mL CSF collected in a sterile leak-proof container or
2 grams fresh (unfixed) tissue or
40 mL urine collected in a sterile, leak-proof container or
1 mL exudates, aspirates, lesion material, ocular specimens collected in a sterile, leak-proof container or
1 gram or 1 mL stool collected in a sterile, leak-proof container
2 mL CSF collected in a sterile leak-proof container or
2 grams fresh (unfixed) tissue or
40 mL urine collected in a sterile, leak-proof container or
1 mL exudates, aspirates, lesion material, ocular specimens collected in a sterile, leak-proof container or
1 gram or 1 mL stool collected in a sterile, leak-proof container
Minimum Volume
2 mL body fluids or lower respiratory tract specimens • 2 mL gastric lavage • 1 mL CSF • 1 gram fresh (unfixed) tissue • 20 mL urine collected in a sterile leak-proof container • 1 mL exudate, aspirate, lesion material, ocular specimen collected in a sterile leak-proof container • 1 gram or 1 mL stool
Other Acceptable Specimens
Swabs in Amies liquid, Amies gel swab, Stuarts or ESwab transport systems, ONLY if tissue biopsy or wound aspirate is not available • Samples in anaerobic transport medium, ONLY if it is an irreplaceable sample type • Throat/oral/sputum swabs from cystic-fibrosis patients
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.
Expectorated sputum: Instruct patient to gargle with water and cough deeply. Three separate early morning collections on at least three consecutive days are recommended.
Gastric lavage fluid: Sterile leak-proof container. Must be neutralized with sodium bicarbonate within 4 hours of collection.
Expectorated sputum: Instruct patient to gargle with water and cough deeply. Three separate early morning collections on at least three consecutive days are recommended.
Transport Temperature
Refrigerated (cold packs)
Specimen Stability
Room temperature: Unacceptable
Refrigerated: 5 days
Frozen: Unacceptable
Refrigerated: 5 days
Frozen: Unacceptable
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
24 hour pooled urine or sputum • Dry swabs • Specimens received in alcohol, formalin, EDTA, lithium heparin or conventional blood culture bottles • Throat/oral/sputum swabs from non-cystic-fibrosis patients • Urine specimens in preservative • Specimens received in expired transport • Specimens that leaked during transit • Specimens broken in transit
Methodology
Continuous Monitoring Broth Culture System and Conventional Culture • Microscopic Exam with Fluorochrome Stain
Setup Schedule
Sets up 7 days a week.
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.