How To Use CPT Code 87070

CPT 87070 is a code used for bacterial culture procedures from any source except urine, blood, or stool, with isolation and presumptive identification of isolates. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 87070 procedures.

1. What is CPT 87070?

CPT 87070 is a code used to describe a laboratory procedure that involves the culturing of a specimen from any source except urine, blood, or stool, with isolation and presumptive identification of bacterial isolates. This code is used by medical professionals to bill for the services provided during this specific type of bacterial culture procedure.

2. 87070 CPT code description

The official description of CPT code 87070 is: “Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates.”

3. Procedure

The procedure for CPT 87070 involves the following steps:

  1. Collection of the specimen from the patient, excluding urine, blood, or stool samples.
  2. Using sterile technique, the lab analyst places the specimen on sterile agar plates to grow any organisms present.
  3. The lab analyst isolates any organisms present and performs presumptive analysis to identify the organism.
  4. If bacterial colonies grow, the lab analyst will classify the organism to the level of presumptive identification, which is based on any or all of the following colony characteristics: type of growth medium that encourages growth of specific bacteria; morphology, or form, of the colony; gram stains; or up to three other tests such as catalase, oxidase, indole, or urease.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 87070 services are those suspected of having an infection and with a specimen not from the urine, blood, or stool. This test may be ordered by healthcare providers for patients presenting with symptoms of infection, such as fever, pain, or inflammation, and when the source of the infection is not from urine, blood, or stool samples.

5. When to use CPT code 87070

It is appropriate to bill the 87070 CPT code when a healthcare provider orders a bacterial culture test for a patient suspected of having an infection, and the specimen is not from urine, blood, or stool. This code should be used for aerobic bacterial cultures from sources such as throat swabs, superficial wound cultures, nasal swabs, sputum, and other similar specimens.

6. Documentation requirements

To support a claim for CPT 87070, the following information needs to be documented:

  • The patient’s medical history and presenting symptoms that led to the decision to order the bacterial culture test.
  • The specific source of the specimen, excluding urine, blood, or stool samples.
  • A detailed description of the procedure, including the steps taken to collect, culture, isolate, and presumptively identify the bacterial isolates.
  • The results of the bacterial culture test, including the identification of any bacterial isolates and their susceptibility to antibiotics, if applicable.

7. Billing guidelines

When billing for CPT code 87070, it is essential to follow the appropriate guidelines and rules. These include:

  • Ensuring that the patient’s medical record contains the necessary documentation to support the claim, as outlined in the documentation requirements section.
  • Using the correct CPT code for the specific type of bacterial culture performed, as there are different codes for cultures from urine, blood, or stool samples.
  • Being aware of any payer-specific rules or guidelines that may apply to billing for CPT 87070, such as prior authorization requirements or limitations on the frequency of testing.

8. Historical information

CPT 87070 was added to the Current Procedural Terminology system on January 1, 1990. There have been updates to the code description since its addition:

  • Code Changed on 01-01-2001: Culture, bacterial, definitive; any other source
  • Code Changed on 01-01-2004: Culture, bacterial; any other source except urine, blood or stool, with isolation and presumptive identification of isolates

9. Similar codes to CPT 87070

There are several similar codes to CPT 87070, which differentiate based on the type of culture and the source of the specimen. These include:

  • CPT 87071: This code is used for anaerobic bacterial cultures from any source except urine, blood, or stool.
  • CPT 87073: This code is used for fungal cultures from any source except urine, blood, or stool.
  • CPT 87075: This code is used for bacterial cultures from blood samples.
  • CPT 87076: This code is used for anaerobic bacterial cultures from blood samples.
  • CPT 87077: This code is used for aerobic and anaerobic bacterial cultures from blood samples.

10. Examples

Here are 10 detailed examples of CPT code 87070 procedures:

  1. A patient presents with a persistent sore throat, and the healthcare provider orders a throat swab culture to test for bacterial infection.
  2. A patient with a skin infection has a superficial wound culture performed to identify the causative bacteria.
  3. A patient with a suspected respiratory infection provides a sputum sample for bacterial culture and identification.
  4. A patient with a suspected sinus infection has a nasal swab culture performed to identify the causative bacteria.
  5. A patient with a suspected eye infection has a conjunctival swab culture performed to identify the causative bacteria.
  6. A patient with a suspected ear infection has an ear swab culture performed to identify the causative bacteria.
  7. A patient with a suspected infection of a surgical wound has a wound swab culture performed to identify the causative bacteria.
  8. A patient with a suspected infection of a burn wound has a wound swab culture performed to identify the causative bacteria.
  9. A patient with a suspected infection of a skin abscess has a wound swab culture performed to identify the causative bacteria.
  10. A patient with a suspected infection of a diabetic foot ulcer has a wound swab culture performed to identify the causative bacteria.

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