87070

Bacterial Culture, Aerobic; Any Other Source (Except Blood)

The CPT code 87070 refers to a fundamental microbiological procedure: the aerobic bacterial culture of specimens from sources other than blood. This test is essential for diagnosing bacterial infections in various clinical sites, including but not limited to wounds, abscesses, body fluids (such as cerebrospinal, pleural, peritoneal, or synovial fluid), and tissue biopsies. The process begins with the careful collection of a specimen using sterile techniques to avoid contamination by commensal flora. Once the specimen arrives at the laboratory, it is inoculated onto appropriate primary culture media, such as sheep blood agar, chocolate agar, and MacConkey agar. These media are selected to support the growth of a wide range of aerobic and facultatively anaerobic pathogens while suppressing others. The plates are incubated at 35 to 37 degrees Celsius in an atmosphere containing 5% to 10% carbon dioxide or ambient air for 24 to 72 hours. Laboratory personnel perform daily visual inspections of the media for signs of microbial growth, noting colony morphology, color, and density. Upon detecting growth, a Gram stain is performed to determine the bacterial shape and cell wall characteristics. Presumptive identification is then achieved through simple biochemical tests such as catalase, oxidase, or coagulase. It is important to note that 87070 covers the isolation and presumptive identification only; definitive identification and antibiotic susceptibility testing are reported using separate CPT codes. This culture is a critical diagnostic tool in managing acute and chronic infections, guiding initial empiric therapy and ensuring appropriate clinical intervention. This code is specifically designated for sources other than blood, stool, or urine, which have dedicated codes, allowing for standardized identification of pathogens from diverse anatomical sites.

Clinical Indications

  • Surgical site infection
  • Deep tissue abscess
  • Cellulitis with purulent drainage
  • Pleural effusion of unknown etiology
  • Peritonitis or suspicious ascitic fluid
  • Suspected bacterial meningitis (Cerebrospinal fluid)
  • Septic arthritis (Synovial fluid)
  • Acute or chronic osteomyelitis
  • Chronic non-healing ulcers with signs of infection
  • Infected burn wounds

Procedure Steps

  1. Sterile collection of the specimen (swab, fluid, or tissue) from the infection site.
  2. Transportation of the specimen to the microbiology laboratory in appropriate transport media.
  3. Inoculation of the specimen onto primary media including blood agar, chocolate agar, and MacConkey agar.
  4. Incubation of the media at 35-37 degrees Celsius for 24 to 72 hours in aerobic conditions.
  5. Daily visual inspection of the plates for bacterial colony growth and morphology.
  6. Gram staining of cultured colonies to determine morphology and cell wall characteristics.
  7. Performance of rapid biochemical tests such as catalase, oxidase, or coagulase for presumptive identification.
  8. Documentation of the growth levels and initial presumptive identification results.

Coding Guidelines

  • Use code 87070 for aerobic cultures from any source except blood, stool, or urine.
  • For blood cultures, report CPT 87040.
  • For stool cultures, report CPT 87045.
  • For urine cultures, report CPT 87086.
  • If definitive identification of isolates is performed (using additional biochemical or molecular methods), report 87077 in addition to 87070.
  • Antibiotic susceptibility testing is not included in 87070 and should be reported separately using codes 87181-87186.
  • A Gram stain performed directly on the initial clinical specimen should be reported separately with CPT 87205.
  • If an anaerobic culture is also performed on the same specimen, report 87075.