How To Use CPT Code 0086U

CPT 0086U describes a proprietary laboratory analysis (PLA) test used for the identification of infectious diseases caused by bacterial and fungal organisms in blood cultures. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0086U.

1. What is CPT Code 0086U?

CPT 0086U is a specific code used to identify a proprietary laboratory analysis (PLA) test. This test is designed to detect and identify bacterial and fungal organisms in blood cultures using a method called rRNA FISH analysis. The test can identify 6 or more organism targets and provides results as positive or negative, along with phenotypic minimum inhibitory concentration (MIC)-based antimicrobial susceptibility.

2. Official Description

The official description of CPT code 0086U is: ‘Infectious disease (bacterial and fungal), organism identification, blood culture, using rRNA FISH, 6 or more organism targets, reported as positive or negative with phenotypic minimum inhibitory concentration (MIC)-based antimicrobial susceptibility.’

3. Procedure

1. The analyst performs a multiplexed diagnostic test using qualitative FISH probes targeting organism-specific ribosomal RNA sequences (rRNA FISH analysis) to identify multiple Gram-positive and Gram-negative bacterial and fungal organisms.
2. The test includes quantitative susceptibility testing of the detected organisms to various antimicrobials (antibiotics) to determine their susceptibility or resistance.
3. A special stain is applied to the specimen, which includes an RNA probe that selectively attaches to the target segment of RNA in the specimen.
4. The probe contains a marker, often a fluorescent molecule, which can be analyzed with a fluorescence microscope to detect and localize the target in the specimen (fluorescence in situ hybridization, or FISH).
5. The results of the test include the identification of specific organisms and their susceptibility or resistance to methicillin and macrolide-lincosamide-streptogramin B (MLSb) antibiotics.

4. Qualifying circumstances

CPT code 0086U is used for patients who require the identification of infectious diseases caused by bacterial and fungal organisms in blood cultures. This test is ordered by clinicians to aid in the diagnosis of bacteremia and fungemia and to determine the susceptibility or resistance of specific pathogenic bacteria to methicillin and MLSb antibiotics.

5. When to use CPT code 0086U

CPT code 0086U should be used when performing the proprietary laboratory analysis (PLA) test described above. It should not be reported with any other CPT code and should only be used for the specific test provided by Accelerate Diagnostics, Inc. using the Accelerate PhenoTest™ BC kit.

6. Documentation requirements

To support a claim for CPT code 0086U, the following documentation is required:

• Identification of the specific infectious diseases being tested
• Description of the rRNA FISH analysis method used
• Date of service and results of the test, including positive or negative identification of organisms and phenotypic minimum inhibitory concentration (MIC)-based antimicrobial susceptibility
• Signature of the analyst performing the test

7. Billing guidelines

When billing for CPT code 0086U, ensure that the test is performed using the Accelerate PhenoTest™ BC kit from Accelerate Diagnostics, Inc. Report one unit of this code for a single specimen analyzed on a single date of service. It is important to check with the appropriate payer regarding separate payment for specimen collection. Do not report this test with any other CPT code.

8. Historical information

CPT code 0086U is a Proprietary Laboratory Analyses (PLA) code that was added to the CPT code set to identify the specific test provided by Accelerate Diagnostics, Inc. using the Accelerate PhenoTest™ BC kit. This code is unique to this specific test and has no historical changes or updates since its addition.

9. Examples

1. A patient with suspected bacteremia undergoes a blood culture, and the CPT code 0086U is used to identify the specific bacterial organisms present and their susceptibility or resistance to antibiotics.
2. A patient with suspected fungemia undergoes a blood culture, and the CPT code 0086U is used to identify the specific fungal organisms present and their susceptibility or resistance to antifungal medications.
3. A clinician orders CPT code 0086U to determine the susceptibility or resistance of a specific bacterial organism to methicillin and MLSb antibiotics in a patient with a known infection.
4. A laboratory performs the rRNA FISH analysis using the Accelerate PhenoTest™ BC kit and reports the results as positive or negative for multiple bacterial and fungal organisms, along with their phenotypic minimum inhibitory concentration (MIC)-based antimicrobial susceptibility.
5. A patient with a suspected bacterial infection undergoes a blood culture, and the CPT code 0086U is used to identify the specific bacterial organisms present and their susceptibility or resistance to a range of antibiotics.
6. A laboratory technician performs the rRNA FISH analysis using the Accelerate PhenoTest™ BC kit and reports the results as positive for multiple Gram-positive and Gram-negative bacterial organisms, along with their susceptibility or resistance to methicillin and MLSb antibiotics.
7. A patient with a suspected fungal infection undergoes a blood culture, and the CPT code 0086U is used to identify the specific fungal organisms present and their susceptibility or resistance to antifungal medications.
8. A laboratory technician analyzes the blood culture using the rRNA FISH analysis method and reports the results as negative for bacterial and fungal organisms, indicating no infection.
9. A clinician orders CPT code 0086U to determine the susceptibility or resistance of a specific bacterial organism to methicillin and MLSb antibiotics in a patient with a known infection.
10. A laboratory performs the proprietary test using the Accelerate PhenoTest™ BC kit and reports the results as positive for multiple bacterial and fungal organisms, along with their phenotypic minimum inhibitory concentration (MIC)-based antimicrobial susceptibility.