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Test Code Billings Clinic: 6606 Culture, Sputum

Additional Codes

Ordering Mnemonic
MayoAccess: BCL252

Performing Laboratory

Billings Clinic Laboratory

Methodology

Includes Gram stain.

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.

Specimen Requirements

Submit only 1 of the following specimens:

 

Induced
1. Fill ultrasonic nebulizer with 10 mL of 3% sterile sodium chloride solution.
2. Seat patient in front of nebulizer.
3. Turn on nebulizer and note strong flow of nebulizer saline from end of flex tubing.
4. Instruct patient to put end of flex tubing inside lips and inhale aerosol slowly and deeply.
5. Instruct patient to cough deeply and expectorate 2 mL of sputum into a screw-capped, sterile container.

Note:  1. 24-Hour sputum collection is not acceptable.
2. “Deep” cough specimen, not saliva, must be collected for an adequate evaluation. Any specimen containing >25 epithelial cells per low-power field will be rejected because of oral contamination.
6. If patient cannot expectorate sputum, 5 to 10 minutes of chest percussion may be administered to stimulate cough and sputum production.

7. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.

8. Maintain sterility and forward promptly at ambient or refrigerated temperature.
Note:  Specimen source is required on request form for processing.

 

Spontaneous
1. Instruct patient to cough deeply and expectorate 2 mL of sputum into a screw-capped, sterile container.

Note:  1. 24-Hour sputum collection is not acceptable.
2. “Deep” cough specimen, not saliva, must be collected for an adequate evaluation. Any specimen containing >25 epithelial cells per low-power field will be rejected because of oral contamination.

 

2. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.

3. Maintain sterility and forward promptly at ambient or refrigerated temperature.
Note:  Specimen source is required on request form for processing.

Reference Values

Normal respiratory flora
Normal flora includes alpha-hemolytic Streptococcus (Viridans group), Neisseria species, coag-negative Staphylococcus, and diphtheroids.
Automatic call-back:  positive for methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus

Day(s) Test Set Up

Monday through Sunday

Test Classification and CPT Coding

CPT Code:

87077 - definitive identification, aerobic; each isolate
87186 - MIC; each isolate

87205 - Gram stain
87070 - isolation and presumptive identification of isolates (anaerobic culture if appropriate)

87106 - culture fungus, definitive identification, yeast (if appropriate)

87107 - culture fungus, definitive identification, mold (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.

Specimen Requirements Additional Information

Laboratory Department(s):  Microbiology

Physician Office Specimen Requirements Additional Information

All