How To Use CPT Code 87230

CPT 87230 describes the process of performing a toxin or antitoxin assay using tissue culture. 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 87230?

CPT 87230 involves conducting an assay to test for a specific toxin, such as the Clostridium difficile toxin, using tissue culture. This test is performed by a laboratory analyst and helps in the diagnosis of certain infections, like Clostridium difficile infection.

2. Official Description

The official description of CPT code 87230 is: ‘Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin).’ This code is used when a lab analyst performs an assay to detect a toxin using tissue culture techniques.

3. Procedure

1. The lab analyst prepares a tissue culture, which involves cultivating specific cells from tissue in an artificial medium with specific nutrients.
2. The analyst extracts the toxin from the specimen, such as a fecal sample, using specific reagents and washes.
3. The extracted toxin is then incubated with the tissue culture cells.
4. The analyst observes the tissue culture for any changes or effects caused by the toxin.
5. If necessary, the analyst may also apply an antitoxin to the culture and observe for any reversal of toxin effects.

4. Qualifying circumstances

CPT 87230 is typically ordered by clinicians to aid in the diagnosis of Clostridium difficile infection. It is especially useful for patients who have recently been hospitalized or taken antibiotics and are experiencing symptoms like frequent watery stools and abdominal pain. However, due to the complexity and cost of performing this test, clinicians may opt for other diagnostic methods.

5. When to use CPT code 87230

CPT code 87230 should be used when a toxin or antitoxin assay is performed using tissue culture techniques. It is appropriate for diagnosing certain infections, such as Clostridium difficile infection. However, clinicians may consider alternative tests due to the challenges associated with performing this assay.

6. Documentation requirements

To support a claim for CPT 87230, the documentation should include:

• Reason for ordering the test, such as suspected Clostridium difficile infection
• Details of the tissue culture technique used
• Date and time of the assay
• Observations of the tissue culture, including any changes or effects caused by the toxin
• Use of an antitoxin, if applicable, and any reversal of toxin effects

7. Billing guidelines

When billing for CPT 87230, ensure that the assay is performed using tissue culture techniques. It is important to follow the specific guidelines for reporting this code and consider any additional codes that may be necessary for a comprehensive billing. It is also important to note that other diagnostic tests may be ordered instead of CPT 87230 due to its complexity and time required for results.

8. Historical information

CPT 87230 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A lab analyst performing a toxin assay using tissue culture to detect Clostridium difficile toxin in a fecal sample.
2. An analyst observing tissue culture changes after incubating a toxin extracted from a patient’s specimen.
3. A lab technician applying an antitoxin to a tissue culture to observe any reversal of toxin effects.
4. An analyst using tissue culture techniques to detect toxins in a sample from a suspected infection.
5. A lab professional documenting observations of tissue culture changes caused by a specific toxin.
6. A technician performing a toxin assay using tissue culture to aid in the diagnosis of a patient’s infection.
7. An analyst preparing a tissue culture for a toxin or antitoxin assay.
8. A lab technician documenting the steps and results of a toxin assay using tissue culture.
9. An analyst using tissue culture techniques to identify the presence of a specific toxin in a patient’s sample.
10. A lab professional performing a toxin assay using tissue culture to confirm a suspected infection.