Test Code Billings Clinic: 6712 Culture and Gram Stain, Bronchial Alveolar Lavage (BAL)
Performing Laboratory
Billings Clinic Laboratory: Microbiology
Methodology
Culture
Gram stain
MIC (minimum inhibitory concentration)
Specimen Requirements
- Bronchial alveolar lavage specimen should be collected by a trained person in the Pulmonary Department.
- Submit ≥10 mL of bronchial alveolar lavage in a screw-capped, sterile container.
- Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
- Maintain sterility and forward promptly at ambient or refrigerated temperature.
- 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
Daily
Test Classification and CPT Coding
CPT Code:
87077 - Culture, bacterial; aerobic isolate, additional methods
required for definitive identification, each isolate
87186 - Susceptibility studies, antimicrobial agent; microdilution
or agar dilution (minimum inhibitory concentration [MIC] or
breakpoint), each multi-antimicrobial, per plate
87205 - Smear, primary source with interpretation; Gram or Giemsa
stain for bacteria, fungi, or cell types
87070 - Culture, bacterial; any other source except urine, blood or
stool, aerobic, with isolation and presumptive identification of
isolates (anaerobic culture 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.
Profile/Testing Information
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.