How To Use CPT Code 87205

CPT 87205 describes the procedure of performing a smear test on a primary source with interpretation using either a Gram or Giemsa stain. 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 87205?

CPT 87205 can be used to describe the procedure of performing a smear test on a primary source with interpretation. This test involves using either a Gram or Giemsa stain to identify bacteria, fungi, or cell types. The analyst performs all steps of the test, including spreading the specimen on a microscope slide, drying or fixing the material onto the glass, and applying the appropriate stain. The findings of the stain are then interpreted by the analyst.

2. Official Description

The official description of CPT code 87205 is: ‘Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types.’

3. Procedure

1. The analyst collects a primary source, such as wounds, aspirations, or sputum, directly from the patient’s body.
2. A thin layer of the specimen is spread onto a microscope slide.
3. The analyst dries or fixes the material onto the glass slide.
4. The appropriate stain, either Gram or Giemsa, is applied to the specimen.
5. The analyst examines the stained specimen under a microscope and interprets the findings, including identifying bacteria, fungi, or cell types.

4. Qualifying circumstances

CPT 87205 is performed when there is a need to quickly assess possible infections before culture results are available. The test is typically ordered by a clinician when there is suspicion of bacterial or fungal presence in a primary source, such as wounds or respiratory secretions. The test is performed by an analyst who has the necessary expertise to interpret the findings of the Gram or Giemsa stain.

5. When to use CPT code 87205

CPT code 87205 should be used when performing a smear test on a primary source with interpretation using either a Gram or Giemsa stain. It is appropriate to bill this code when the analyst performs all steps of the test and provides an interpretation of the findings. This code should not be used for other types of stains or procedures.

6. Documentation requirements

To support a claim for CPT 87205, the documentation should include:

• Reason for ordering the smear test
• Details of the primary source used for the test
• Type of stain used (Gram or Giemsa)
• Date and time of the test
• Interpretation of the findings
• Signature of the analyst performing the test

7. Billing guidelines

When billing for CPT 87205, ensure that the procedure includes all the necessary steps and interpretation of the findings. This code should not be reported with other codes unless there are specific circumstances that warrant additional codes. It is important to follow the guidelines provided by the payer and accurately document the services provided.

8. Historical information

CPT 87205 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2001 to include the option of using a Giemsa stain in addition to the Gram stain. There have been no further updates to the code since then.

9. Examples

1. An analyst performs a smear test on a wound specimen using a Gram stain and interprets the findings to identify the presence of bacteria.
2. A sputum sample is collected from a patient suspected of having a respiratory infection. The analyst performs a smear test using a Giemsa stain and identifies fungal elements in the specimen.
3. A clinician orders a smear test on an aspirated fluid sample to assess for the presence of specific cell types. The analyst performs the test using a Gram stain and provides an interpretation of the findings.
4. An analyst performs a smear test on a nasal passage specimen using a Giemsa stain and identifies mast cells, which may indicate an allergic reaction.
5. A wound sample is collected from a patient with suspected bacterial infection. The analyst performs a smear test using a Gram stain and interprets the findings to identify the type and quantity of bacteria present.
6. A clinician orders a smear test on a conjunctival specimen to assess for the presence of Chlamydia bacteria. The analyst performs the test using a Giemsa stain and provides an interpretation of the findings.
7. An analyst performs a smear test on a specimen collected from a patient with suspected fungal infection. The test is performed using a Gram stain, and the analyst identifies fungal elements in the specimen.
8. A clinician orders a smear test on a wound sample to assess for the presence of specific cell types. The analyst performs the test using a Giemsa stain and provides an interpretation of the findings.
9. An analyst performs a smear test on a respiratory secretion sample using a Gram stain and identifies the presence of bacteria.
10. A clinician orders a smear test on a wound specimen to assess for the presence of specific cell types. The analyst performs the test using a Giemsa stain and provides an interpretation of the findings.