How To Use CPT Code 87154

CPT 87154 describes the process of culture, typing, and identification of blood pathogens using nucleic acid probe techniques. 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 87154?

CPT 87154 can be used to describe the culture, typing, and identification of blood pathogens using nucleic acid probe techniques. This code is used when the laboratory analyst performs further testing on a previously cultured blood specimen or isolate to identify the pathogenic organism to the taxonomic level of type. The test involves amplifying the DNA or RNA targets in the specimen and using probes for multiple targets to specifically identify the organism and its resistance to medications.

2. Official Description

The official description of CPT code 87154 is: ‘Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets.’

3. Procedure

1. The laboratory analyst starts with a previously cultured blood specimen or isolate that has been definitively identified to the genus and species level.
2. The analyst performs further testing using nucleic acid probe techniques to specifically identify the taxonomic type of the isolated organism and its resistance to medications.
3. The procedure includes amplification techniques, such as polymerase chain reaction (PCR) and reverse transcription PCR, to increase the number of copies of specific nucleic acid sequences for at least six targets.
4. The test is multiplexed, meaning it uses multiple nucleic acid probes that join with the complementary target sequences in the specimen.
5. The presence of the targets in the specimen is visualized using labels, such as fluorescent tags, attached to the probes.

4. Qualifying circumstances

CPT 87154 is performed following a separate procedure on a blood specimen to culture, isolate, and definitively identify a pathogenic organism to the genus and species level. The test is used to further type the organism and determine its resistance to medications. It is typically ordered in cases of sepsis, a serious blood infection, to help clinicians select appropriate and timely treatment.

5. When to use CPT code 87154

CPT code 87154 should be used when the laboratory performs culture, typing, and identification of blood pathogens using nucleic acid probe techniques. It is important to note that this code is specifically for culture isolates and not for direct smear specimens. If the laboratory uses nucleic acid probes to identify a specific organism from a direct smear specimen, different codes should be used.

6. Documentation requirements

To support a claim for CPT 87154, the laboratory should document the following information:

• Details of the initial culture and definitive identification of the pathogenic organism to the genus and species level
• Description of the nucleic acid probe techniques used for further typing and resistance testing
• Date and time of the procedure
• Number of targets amplified and identified
• Results of the typing and resistance testing
• Signature of the laboratory analyst performing the procedure

7. Billing guidelines

When billing for CPT 87154, ensure that the procedure meets the criteria specified in the official description. It is important to code first the procedures for culture and identification of the organism to the genus and species level before reporting CPT 87154. Additionally, be aware of any specific guidelines or modifiers that may apply when reporting this code.

8. Historical information

CPT 87154 was added to the Current Procedural Terminology system on January 1, 2022. There have been no updates or changes to the code since its addition.

9. Examples

1. A laboratory analyst performs culture, typing, and identification of a blood pathogen using nucleic acid probe techniques for a patient with suspected sepsis.
2. Following the initial culture and identification of a pathogenic organism, the laboratory performs further testing to determine the taxonomic type and resistance of the isolated organism.
3. A blood specimen is processed using nucleic acid probe techniques to identify the presence of at least six targets that help specifically identify the organism and its resistance to medications.
4. The laboratory analyst visualizes the presence of the targets in the specimen using fluorescent tags attached to the nucleic acid probes.
5. The results of the culture, typing, and identification procedure are documented and reported to the healthcare provider for appropriate treatment decisions.