How To Use CPT Code 87197

CPT 87197 describes the serum bactericidal titer (Schlichter test) performed by a lab analyst using patient serum to determine susceptibility to a specific antibiotic dosage. 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 87197?

CPT 87197 can be used to describe the serum bactericidal titer (Schlichter test) performed by a lab analyst using patient serum to determine susceptibility to a specific antibiotic dosage. This test involves culturing, isolating, and specifically identifying an organism, such as a bacterium, and administering an antimicrobial agent to the patient. The lab analyst then performs a serum bacterial titer test using blood specimens drawn before and after the antibiotic dosage to determine the maximum serum dilution that kills a significant percentage of the infecting bacterial organism.

2. Official Description

The official description of CPT code 87197 is: ‘Serum bactericidal titer (Schlichter test).’ This test is performed by a lab analyst using patient serum to determine the maximum serum dilution that kills greater than or equal to 99.9 percent of the infecting bacterial organism.

3. Procedure

1. Following a separate procedure to culture, isolate, and specifically identify an organism, such as a bacterium, the lab analyst collects two blood specimens from the patient.
2. The first blood specimen, known as the trough antibiotic level, is drawn just prior to the patient receiving the antibiotic dosage.
3. The second blood specimen, known as the peak level, is drawn at a specific time period after the patient receives the antibiotic dosage, depending on the method of administration.
4. The lab analyst performs serial dilution on the two serum specimens, repeatedly diluting the samples by a known amount to determine the maximum serum dilution that kills greater than or equal to 99.9 percent of the infecting bacterial organism.

4. Qualifying circumstances

CPT 87197 may be ordered by clinicians for patients with life-threatening bacterial infections, such as endocarditis or osteomyelitis. This test helps determine the likely usefulness of the patient’s antibiotic dosage by ensuring adequate levels of antibiotic in the patient’s serum throughout the dosage cycle. It is not limited to use for a specific condition.

5. When to use CPT code 87197

CPT code 87197 should be used when a lab analyst performs a serum bactericidal titer (Schlichter test) using patient serum to determine susceptibility to a specific antibiotic dosage. This code is appropriate when the test is performed to assess the likely effectiveness of the antibiotic dosage in treating a life-threatening bacterial infection.

6. Documentation requirements

To support a claim for CPT 87197, the following documentation is required:

• Separate procedure documentation for culturing, isolating, and specifically identifying the organism
• Documentation of the trough antibiotic level blood specimen drawn just prior to the patient receiving the antibiotic dosage
• Documentation of the peak level blood specimen drawn at a specific time period after the patient receives the antibiotic dosage
• Serial dilution results and determination of the maximum serum dilution that kills greater than or equal to 99.9 percent of the infecting bacterial organism

7. Billing guidelines

When billing for CPT 87197, ensure that the test is performed by a lab analyst using patient serum to determine susceptibility to a specific antibiotic dosage. There are no specific guidelines regarding reporting CPT 87197 with other codes. However, it is important to follow any applicable payer-specific guidelines and provide appropriate documentation to support the medical necessity of the test.

8. Historical information

CPT 87197 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2017, to its current description of ‘Serum bactericidal titer (Schlichter test).’ No further updates have been made to the code since its addition.

9. Examples

1. A lab analyst performs a serum bactericidal titer (Schlichter test) using patient serum to determine susceptibility to a specific antibiotic dosage for a patient with endocarditis.
2. Following the administration of an antimicrobial agent to a patient with osteomyelitis, a lab analyst performs a serum bactericidal titer (Schlichter test) to assess the likely effectiveness of the antibiotic dosage.
3. A clinician orders a serum bactericidal titer (Schlichter test) for a patient with a life-threatening bacterial infection to ensure adequate levels of antibiotic in the patient’s serum throughout the dosage cycle.
4. During the treatment of a patient with a severe bacterial infection, a lab analyst performs a serum bactericidal titer (Schlichter test) to determine the maximum serum dilution that kills a significant percentage of the infecting bacterial organism.
5. A patient with a suspected bacterial infection undergoes a serum bactericidal titer (Schlichter test) to assess the likely effectiveness of the antibiotic dosage in treating the infection.
6. Following the administration of an antibiotic dosage to a patient with a bacterial infection, a lab analyst performs a serum bactericidal titer (Schlichter test) to ensure adequate levels of antibiotic in the patient’s serum throughout the dosage cycle.
7. A clinician orders a serum bactericidal titer (Schlichter test) for a patient with a suspected antibiotic-resistant bacterial infection to determine the maximum serum dilution that kills the infecting bacterial organism.
8. During the treatment of a patient with a recurrent bacterial infection, a lab analyst performs a serum bactericidal titer (Schlichter test) to assess the effectiveness of the antibiotic dosage.