How To Use CPT Code 87040

CPT 87040 describes the process of performing a bacterial culture on blood, including the isolation and presumptive identification of any bacteria that grow on selected aerobic media. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 87040?

CPT 87040 can be used to describe the laboratory procedure of performing a bacterial culture on blood. This involves collecting a blood sample from a patient using aseptic techniques and placing it in aerobic blood culture bottles. The bottles are then incubated in an automated incubator for up to five days or until bacterial growth occurs. The lab analyst will then isolate the bacteria and make a presumptive identification based on various criteria.

2. Official Description

The official description of CPT code 87040 is: ‘Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate).’ This code includes the work for anaerobic culture when performed.

3. Procedure

1. The collecting provider obtains a blood sample from the patient using aseptic techniques.
2. The blood sample is placed in aerobic blood culture bottles.
3. The bottles are incubated in an automated incubator for up to five days or until bacterial growth occurs.
4. The lab analyst places a small amount of the blood onto agar culture media plates to isolate the bacteria.
5. The plates are incubated for a specific time or until bacterial growth is observed.
6. The lab analyst makes a presumptive identification of the bacteria based on various criteria such as selective media, colony morphology, reagent tests, and gram stain.

4. Qualifying circumstances

CPT 87040 is performed when a bacterial culture on blood is necessary for the diagnosis and management of a patient’s condition. This procedure is typically ordered for patients experiencing symptoms such as sepsis, fever, shortness of breath, or rapid heartbeat. It is important to collect the blood sample before administering antibiotics to obtain accurate results. The lab analyst performing the procedure must follow aseptic techniques and use appropriate culture media and incubation conditions.

5. When to use CPT code 87040

CPT code 87040 should be used when a bacterial culture on blood is performed, specifically for aerobic cultures. This code includes the isolation and presumptive identification of isolates. If anaerobic culture is also performed, it is included in this code. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 87040, the documentation should include:

• Reason for ordering the bacterial culture on blood
• Details of the blood collection procedure
• Information on the culture media and incubation conditions used
• Observations and findings during the isolation and presumptive identification process
• Signature of the lab analyst performing the procedure

7. Billing guidelines

When billing for CPT 87040, ensure that the procedure meets the specific criteria outlined in the code description. It is important to document the necessary information and follow the appropriate coding guidelines. CPT code 87040 should not be reported with other codes unless specific circumstances warrant it. It is important to review the billing guidelines and any applicable modifiers to ensure accurate and appropriate reimbursement.

8. Historical information

CPT 87040 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including code changes in 2001 and 2004. The code description was modified to its current form, including the inclusion of anaerobic culture when appropriate.

9. Examples

1. A lab analyst performs a bacterial culture on blood collected from a patient with suspected sepsis.
2. A physician orders a bacterial culture on blood for a patient presenting with a high fever and rapid heartbeat.
3. A lab technician isolates and makes a presumptive identification of bacteria from a blood sample collected from a patient with shortness of breath.
4. A nurse collects a blood sample from a patient with suspected infection, and the lab analyst performs a bacterial culture to identify the causative organism.
5. A lab analyst performs a bacterial culture on blood obtained from a patient before administering antibiotics to determine the appropriate treatment.
6. A physician orders a bacterial culture on blood for a patient with a suspected bacterial infection.
7. A lab technician isolates and makes a presumptive identification of bacteria from a blood sample collected from a patient with a fever of unknown origin.
8. A nurse collects a blood sample from a patient with symptoms of sepsis, and the lab analyst performs a bacterial culture to aid in diagnosis.
9. A lab analyst performs a bacterial culture on blood obtained from a patient with a suspected bloodstream infection.
10. A physician orders a bacterial culture on blood for a patient with a history of recurrent infections.