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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

  1. Bronchial alveolar lavage specimen should be collected by a trained person in the Pulmonary Department.
  2. Submit ≥10 mL of bronchial alveolar lavage in a screw-capped, sterile container. 
  3. Label container with patient’s name (first and last), date and actual time of collection, and type of specimen.
  4. Maintain sterility and forward promptly at ambient or refrigerated temperature.
  5. 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.