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HelpTest Code Billings Clinic: 6650 Culture, Urine
Additional Codes
| Ordering Mnemonic |
|---|
| MayoAccess: BCL254 |
Performing Laboratory
Billings Clinic Laboratory: Microbiology
Methodology
Reflex Information:
If colony count is ≥10,000 organisms and specimen is not contaminated, sensitivity will be performed unless other arrangements have been made.
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
Specimen must arrive within 2 hours of collection.
- Specimens sent in a BD vacutainer urine preservative tube are stable for 72 hours either at room temperature or refrigerated.
Submit 2 mL of urine from a first-morning specimen. Follow directions below for collection. Overnight incubation in bladder yields highest bacterial counts.
Submit only 1 of the following specimens:
Catheterized
1. Do not collect urine from drainage bag.
2. Disinfect catheter collection port with 70% alcohol.
3. Use a port to aseptically collect urine.
4. Transfer specimen to a sterile urine container with a tightly-fitting lid.
5. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
6. Maintain sterility and forward promptly. If there is a delay in transport of ≥1 hour, send specimen refrigerated.
Note: 1. Specimen source is required on request form for processing.
2. Label specimen appropriately (catheterized urine).
Clean-Catch, Midstream
Males
1. Clean glans with soap and water or benzalkonium chloride antiseptic towelette.
2. Rinse area with water or wet gauze pads.
3. While holding foreskin retracted, begin voiding.
4. After several mL have passed, collect specimen without stopping flow of urine into a sterile urine container with tightly-fitting lid.
5. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
6. Maintain sterility and forward promptly. If there is a delay in transport of ≥1 hour, send specimen refrigerated.
Note: 1. Specimen source is required on request form for processing.
2. Label specimen appropriately (clean-catch, midstream urine).
Females
1. Thoroughly clean urethral area with soap and water or benzalkonium chloride antiseptic towelette.
2. Rinse area with water or wet gauze pads.
3. While holding labia apart, begin voiding.
4. After several mL have passed, collect specimen without stopping flow of urine into a sterile urine container with tightly-fitting lid.
5. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
6. Maintain sterility and forward promptly. If there is a delay in transport of ≥1 hour, send specimen refrigerated.
Note: 1. Specimen source is required on request form for processing.
2. Label specimen appropriately (clean-catch, mid-stream urine).
Voided Urine (Infants or Small Children)
1. Thoroughly clean urethral area or glans with soap and water or benzalkonium chloride antiseptic towelette.
2. Place sterile urine bag over labia or penis.
3. After 30 minutes, observe for presence of urine. If no urine is present, reclean patient and attach a new bag.
Note: If impossible to obtain urine or if culture results yield a mixture of organisms, a suprapubic aspiration is recommended.
4. Transfer specimen to a sterile urine container with a tightly-fitting lid.
5. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
6. Maintain sterility and forward promptly. If there is a delay in transport of ≥1 hour, send specimen refrigerated.
Note: 1. Specimen source is required on request form for processing.
2. Label specimen appropriately (voided urine).
Suprapubic Aspiration
1. Expose area above pubis.
2. Scrub area with povidone-iodine surgical scrub. Cover area with povidone-iodine solution. Allow to dry.
3. Using a sterile needle and syringe, aspirate urine from bladder.
4. Transfer specimen to a sterile urine container with a tightly-fitting lid.
5. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
6. Maintain sterility and forward promptly. If there is a delay in transport of ≥1 hour, send specimen refrigerated.
Note: 1. Specimen source is required on request form for processing.
2. Label specimen appropriately (suprapubic aspiration urine).
Reference Values
No growth
Automatic call-back: positive for methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus
Day(s) Test Set Up
Daily
Test Classification and CPT Coding
CPT Code:
87077 - definitive identification, aerobic; each isolate
87086 - culture and colony count
87088 - isolation and presumptive identification
87186 - MIC; each isolate
LCD or NCD test. ICD-10 code is required for this test. When appropriate, obtain a properly executed ABN and submit the ABN with test order(s). See “Medical Necessity and Advanced Beneficiary Notice (ABN) Policy and Form” in “Special Instructions” for a copy of a form and additional information.
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.