2025 CPT code 87086

This code represents a quantitative bacterial urine culture, measuring the number of bacterial colonies in a urine sample.

Follow CPT guidelines for microbiology procedures, specifically regarding the reporting of additional tests like isolation and identification (87088) and antimicrobial susceptibility testing (87184, 87186) if performed. Modifier 59 may be used if multiple specimens or sites are tested, and modifier 91 if the test is repeated on the same day.

Modifiers 59 and 91 are applicable based on the specific circumstances.

Medical necessity for 87086 is established when there is clinical suspicion of a UTI based on symptoms, abnormal urinalysis findings, or risk factors like pregnancy or urological procedures.Payers may have specific criteria for coverage.

The clinical responsibility lies with the laboratory personnel who perform the culture and quantify the bacterial growth.The ordering physician is responsible for interpreting the results and determining appropriate treatment.

IMPORTANT If further identification (presumptive or definitive) or antimicrobial susceptibility testing is performed, additional codes such as 87088, 87077, 87184, and 87186 may be used depending on the specifics of the tests performed.These are reported separately.

In simple words: This lab test checks a urine sample for bacteria. It counts how many bacteria are present to help find out if you have a urinary tract infection (UTI).

CPT code 87086 describes a quantitative bacterial culture of a urine specimen.The procedure involves culturing the urine sample to determine the number of bacterial colonies present.This count is expressed as colony-forming units (CFU) per milliliter and helps assess the presence and severity of a urinary tract infection (UTI). The method typically includes the inoculation of the specimen onto appropriate growth media followed by incubation and quantification of bacterial growth.Additional procedures such as identification and susceptibility testing might be reported separately.

Example 1: A patient presents with symptoms of a UTI (dysuria, frequency, urgency). A urine sample is collected, and the culture (87086) reveals a high colony count of *E. coli*, indicating a UTI.Further testing (87088, 87184) may be performed to identify the organism definitively and determine antibiotic susceptibility., A pregnant patient undergoes routine urine testing.The culture (87086) reveals a significant number of bacteria, prompting further evaluation and management to prevent complications., A patient is scheduled for a urological procedure. A pre-procedure urine culture (87086) is performed to screen for infection and guide treatment if necessary.A negative result allows the procedure to proceed.

* Patient demographics and identification* Date and time of specimen collection* Specimen type (urine) and collection method (clean-catch, catheterized)* Relevant clinical information (symptoms, history)* Results of the quantitative bacterial culture (colony count)* Report indicating the presence or absence of significant bacterial growth.

** The interpretation of the quantitative colony count depends on clinical context.A high colony count of a single organism strongly suggests a UTI, whereas low counts or mixed flora may indicate contamination.Always consult laboratory reports and clinical findings for accurate interpretation and coding.

  • Revenue Code: T1F (LAB TESTS - BACTERIAL CULTURES)
  • RVU: The RVUs for this code vary based on location, payer, and other factors.Consult your specific payer's fee schedule for current values.
  • Global Days : Not applicable. This is a laboratory test; there is no global period.
  • Payment Status: Active
  • Modifier TC rule: Not applicable. This is a complete laboratory test code.
  • Fee Schedule : Fee schedules vary by payer and location.Historical fee data can be obtained from past payer fee files.
  • Specialties:Urology, Nephrology, Internal Medicine, Family Medicine, Infectious Disease
  • Place of Service:Office, Hospital (Inpatient and Outpatient), Laboratory, Urgent Care, Other Place of Service
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