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Test Code Billings Clinic: 6643 Culture, Stool, Panel

Additional Codes

Ordering Mnemonic
MayoAccess: BCL253

Performing Laboratory

Billings Clinic Laboratory:  Microbiology

Methodology

This culture checks for the following enteric pathogens:  Campylobacter, Escherichia coli O157, Salmonella, and Shigella.

 

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.

 

General Information:

Stool cultures are not done on patients hospitalized for ≥72 hours.
Inform Microbiology Department IN ADVANCE if Vibrio or Yersinia species are suspected.

Specimen Requirements

Unpreserved specimen must arrive within 1 hour of collection.

  • If there is a delay in transport of ≥1 hour, use stool transport system (orange-capped vial) instead of plain leak-proof container.

Submit only 1 of the following specimens:

 

Feces

  1. Submit stool in a clean, dry, leak-proof container with a tightly-fitting lid.
  2. If specimen is collected in a bedpan or collection “hat,” patient should urinate into another container before stool specimen is collected. Do not collect specimen from toilet.
  3. Those portions of stool containing blood and mucus are especially significant and should be transferred into container
  4. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
  5. Specimen source is required on request form for processing.

Note:  Specimen in diaper is not acceptable. Stool material should be scraped into a clean, dry, leak-proof container with a tightly-fitting lid. Pediatric patients with severe diarrhea may use a U-Bag® Collection System. Place bag over anal area in an attempt to retrieve specimen before it soaks into diaper.


Rectal Swab

  1. If a stool specimen is unobtainable, a rectal swab is acceptable.
  2. Carefully insert swab approximately 1 inch beyond anal sphincter.
  3. Gently rotate swab to sample anal crypts. Feces should be evident on swab. Do not collect specimen from toilet.
  4. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
  5. Specimen source is required on request form for processing.

Reject Due To

  • Leaking specimen container.
  • Specimen contaminated with urine and/or water.
  • Specimen in diaper.
  • Unpreserved specimen >1 hour old.
     

Reference Values

  • Negative for Campylobacter, Escherichia coli O157, Salmonella, and Shigella
  • Automatic call-back:  any positive
  • All positive results will be sent to the City/County Health Nurse as per Montana state law.

Day(s) Test Set Up

Monday through Sunday

Test Classification and CPT Coding

CPT Code:

87045 x 2 - stool aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species

87046 x 2 - stool aerobic, with isolation and presumptive identification of isolates

87015 - concentration for infectious agents
 

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.