How To Use CPT Code 87187

CPT 87187 describes the process of conducting susceptibility studies for antimicrobial agents. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 87187?

CPT 87187 can be used to describe the minimum lethal concentration (MLC) determination for an antimicrobial agent. This test is performed by a lab analyst to determine the concentration of the antimicrobial agent that will kill the specific culture isolate. The MLC test is also known as the minimal bactericidal concentration (MBC) test. One unit of CPT 87187 represents a single test plate.

2. Official Description

The official description of CPT code 87187 is: ‘Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each plate (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT codes 87186 or 87188.

3. Procedure

1. The lab analyst performs the MLC test to determine the minimum lethal concentration of an antimicrobial agent for a specific culture isolate.
2. The MLC test is performed after a minimum inhibitory concentration (MIC) test, such as CPT 87186 or 87188.
3. The lab analyst subcultures the last clear MIC tube onto an agar plate and examines it for growth.
4. If there is growth, the lab analyst performs additional serial dilutions to find the lowest concentration resulting in no bacterial growth.
5. The concentration that kills the organism is recorded as the MLC or MBC.

4. Qualifying circumstances

CPT 87187 is typically ordered by clinicians to aid in selecting the appropriate dosage level of an antibiotic for treating an infection. It is not limited to a specific condition, but it is commonly used in critical infections such as bacteremia and endocarditis. The test is performed on the organism isolated from the patient, and the results guide therapy decisions.

5. When to use CPT code 87187

CPT code 87187 should be used when conducting susceptibility studies to determine the minimum lethal concentration of an antimicrobial agent. It is important to note that this code should be reported in addition to the appropriate primary code for the initial test, such as CPT 87186 or 87188.

6. Documentation requirements

To support a claim for CPT 87187, the documentation should include:

• Indication for the test and the need for determining the minimum lethal concentration
• Results of the MIC test (CPT 87186 or 87188)
• Date and time of the MLC test
• Details of the specific antimicrobial agent used
• Concentration of the antimicrobial agent that resulted in no bacterial growth
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87187, it is important to report it in addition to the appropriate primary code for the initial test (CPT 87186 or 87188). Payers will not reimburse for CPT 87187 if it is not reported with the primary code. There are no specific guidelines regarding reporting CPT 87187 with other codes.

8. Historical information

CPT 87187 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including the addition of the MBC terminology and the requirement to report it in addition to CPT 87186 or 87188.

9. Examples

1. A lab analyst performing the MLC test to determine the minimum lethal concentration of an antimicrobial agent for a culture isolate obtained from a patient with a severe infection.
2. A clinician ordering the MLC test to guide therapy decisions for a patient with endocarditis caused by a specific organism.
3. A lab technician conducting the MLC test to determine the appropriate dosage level of an antibiotic for a patient with a resistant bacterial infection.
4. A microbiologist performing the MLC test to assess the effectiveness of different antimicrobial agents against a specific culture isolate.
5. A lab analyst subculturing the last clear MIC tube onto an agar plate and performing serial dilutions to find the lowest concentration resulting in no bacterial growth.
6. A clinician ordering the MLC test to determine the minimum lethal concentration of an antimicrobial agent for a patient with a recurrent infection.
7. A lab technician recording the concentration of the antimicrobial agent that kills the organism as the MLC or MBC.
8. A microbiologist analyzing the results of the MLC test to guide the selection of an appropriate antibiotic for a patient with a multidrug-resistant infection.
9. A lab analyst performing the MLC test to assess the susceptibility of a specific culture isolate to different antimicrobial agents.
10. A clinician ordering the MLC test to determine the minimum lethal concentration of an antimicrobial agent for a patient with a complicated urinary tract infection.