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Test Code Billings Clinic: 6602 Culture, Blood (Aerobic and Anaerobic)

Additional Codes

Ordering Mnemonic
MayoAccess: BCL308

Performing Laboratory

Billings Clinic Laboratory - Microbiology

Methodology

Reflex Information:This test may automatically reflex to other tests. An additional fee may be added. The ordering physician/provider must indicate if the reflex test is NOT DESIRED. Indicate on order if no reflex test is desired.

Method Name:

BacT/ALERT® Instrumentation

Versa TREK Instrumentation

Specimen Requirements

Draw blood cultures before starting antimicrobial therapy. It is recommended to draw at least 2 blood culture sets per septic episode as chances of recovering a pathogenic organism increase with additional cultures. No more than 6 blood cultures will be allowed on any patient during a 24-hour period. Any more than 6 has proven to be unproductive by research found in literature.

 

Collect specimens using BacT/ALERT® blood culture bottles as follows:

  1. Disinfect stopper of bottle with 70% alcohol and allow to dry.
  2. Thoroughly cleanse venipuncture site with 70% alcohol moving in concentric circles to periphery.
  3. Blood culture set consists of 2 bottles, 1 aerobic and 1 anaerobic.
  4. Draw 5 mL to 10 mL of blood per bottle for adults, filling first the anaerobic bottle then the aerobic bottle.
  5. Label bottles with patient’s name (first and last), date and actual time of collection, and site specimen was collected from (i.e. right AC, central line, etc.).
  6. Maintain sterility and forward promptly at ambient temperature only. Do not refrigerate.

NOTES:

  1. Blood cultures should not be drawn through a line unless they cannot be obtained by venipuncture. If drawn from a line, discard first 5 mL, unless the line is to be cultured.
  2. Method of specimen collection and amount of blood drawn directly influence the success of the recovery of isolates and interpretation of results.
  3. Factors directly influencing culture results:
    a. Volume of blood drawn is perhaps the most important factor.
    b. Method of skin disinfection is also critical.

Difficult Adult/Neonates/Infants/Children:

 

Main Campus Only

  1. Draw 0.5 mL to 5 mL of blood per bottle.
  2. Fill 1 Versa TREK anaerobic bottle (color coded red)
  3. Fill 1 Versa TREK aerobic bottle (color coded silver)
  4. Versa TREK bottles are glass and cannot be tubed.  Bottles MUST be walked to lab.

All other areas

  1. Draw 1 mL to 4 mL of blood.
  2. Fill 1 Pediatric BacT/ALERT® bottle (color codes yellow)

 NOTES:

  1. Do not use Chlorhexidine gluconate prep on neonates < 2 months of age
  2. Use povidone iodine prep.

Reference Values

No growth
Automatic call-back:  any positive

Day(s) Test Set Up

Daily

Test Classification and CPT Coding

CPT Code:

87040 - isolation and presumptive identification of isolates
87076 - definitive identification, anaerobic; each isolate (if appropriate)
87077 - definitive identification, aerobic; each isolate (if appropriate)
87186 - MIC; each isolate (if appropriate)

Microbiology Coding:
Proper coding for MICROBIOLOGY tests depends on what procedures are actually performed which may depend on the organism(s) isolated. When a culture is initially set up, organism(s) may be isolated and a presumptive identification takes place. When/if an organism(s) grows, a definitive identification and possible MIC of each organism may be indicated.