2025 CPT code 87088

Urine culture with isolation and presumptive identification of each isolate.

Follow CPT guidelines for microbiology procedures, including those related to presumptive and definitive identification. Modifier 59 may be appended if multiple specimens or sites are cultured. Modifier 91 is used for repeat tests on the same day.

Modifiers 59 and 91 are applicable as described above.Other modifiers may apply depending on the specific circumstances of service.

Medical necessity for a urine culture with presumptive identification (87088) is established when the physician has clinical suspicion of a urinary tract infection (UTI) based on patient symptoms (dysuria, frequency, urgency, etc.) and/or abnormal urinalysis findings. Other scenarios include asymptomatic bacteriuria screening in pregnant women or patients undergoing urological procedures. The absence of such clinical indications would render the test not medically necessary.

The clinical responsibility lies with the laboratory personnel (medical technologist or microbiologist) who perform the urine culture and interpret the results. The ordering physician is responsible for the medical necessity of the test and interpretation in the context of the patient's clinical presentation.

IMPORTANT Code 87086 (Culture, bacterial; quantitative colony count, urine) is used for quantitative urine cultures. Code 87077 (Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate) is used for definitive identification of isolates. Code 87081 (Culture, presumptive, pathogenic organisms, screening only) is used for basic presumptive identification, usually before more in-depth testing.If additional molecular studies are done, codes 87140-87158 should also be used.

In simple words: This lab test checks a urine sample for bacteria. It identifies the type of bacteria present using basic tests, but may not be totally precise in identifying it.

This CPT code reports a bacterial urine culture that includes the isolation and presumptive identification of each bacterial isolate. Presumptive identification relies on colony morphology, growth on selective media, Gram stains, and up to three additional tests (e.g., catalase, oxidase, indole, urease). Definitive identification, requiring more extensive testing, is coded separately (e.g., 87077).The procedure is performed on urine cultures showing bacterial growth and is not the primary code for quantitative urine cultures (e.g., 87086).

Example 1: A patient presents with symptoms of a urinary tract infection (UTI). A urine culture is ordered, and code 87088 is used to report the isolation and presumptive identification of *E. coli*., A patient has a positive dipstick urinalysis suggestive of a UTI. A urine culture is performed and reports growth, with code 87088 used to report the presumptive identification of *Staphylococcus saprophyticus*., A pregnant woman undergoes routine screening for asymptomatic bacteriuria.The urine culture shows growth, and code 87088 is reported following presumptive identification of *Enterococcus faecalis*.

* Properly collected urine specimen (midstream clean-catch or catheterized specimen).* Gram stain results.* Colony morphology descriptions (size, shape, color).* Results of up to three additional tests used for presumptive identification (e.g., catalase, oxidase, indole).* Laboratory report documenting the isolation and identification of each isolate.* Physician order for the urine culture.

** This code is used when presumptive identification of the microorganism is sufficient for clinical management. If definitive identification is required, additional codes (e.g., 87077) should be used.Always ensure accurate and complete documentation supports the medical necessity of the test.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.