2025 CPT code 87185
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Antimicrobial Susceptibility Studies Pathology and Laboratory Procedures > Microbiology Procedures Feed
Susceptibility studies, antimicrobial agent; enzyme detection (e.g., beta-lactamase), per enzyme.
Modifiers 59 and 91 are applicable.Other modifiers may apply depending on the clinical context and payer-specific guidelines.
Medical necessity for 87185 is established when there is a suspicion of bacterial infection requiring targeted antibiotic therapy. Results of the beta-lactamase test directly impact antibiotic selection, aiding in optimal treatment and reducing the risk of antibiotic resistance.Documentation of the infection and the rationale for choosing this test are crucial.
The clinical responsibility lies with the physician who orders the test to guide antibiotic selection for treating an infection. The laboratory technician performs the technical aspects of the beta-lactamase test.
- Pathology and Laboratory Procedures > Microbiology Procedures
- Microbiology Procedures; Antimicrobial Susceptibility Studies
In simple words: The lab checks how well a bacteria responds to antibiotics by looking for certain enzymes it might make. This helps doctors choose the best antibiotic to fight the infection.
This CPT code 87185 encompasses the laboratory analysis to determine the susceptibility of a microbial isolate to antimicrobial agents by detecting the production of specific enzymes, such as beta-lactamase.The procedure involves inoculating a culture isolate onto a specialized agar plate designed to detect the target enzyme.After incubation, the presence or absence of enzyme activity is determined by observing changes in the agar, such as color changes or growth patterns. The result aids in antibiotic selection for treating infections caused by the identified microorganism.
Example 1: A patient presents with a wound infection. Cultures reveal the presence of *Bacteroides fragilis*. A beta-lactamase test (87185) is ordered to determine if the bacteria produces beta-lactamase, which would indicate resistance to penicillin-based antibiotics. The results help the physician select an appropriate antibiotic., A patient with suspected pneumonia has sputum cultures showing *Haemophilus influenzae*. A beta-lactamase test (87185) is performed to evaluate the bacteria's susceptibility to amoxicillin. If beta-lactamase is present, the physician would choose a different antibiotic, such as a cephalosporin., A patient is admitted with a serious bloodstream infection. Cultures reveal *Staphylococcus aureus*. The physician orders a rapid beta-lactamase test (87185) to quickly assess resistance to penicillin.The results guide the immediate choice of empiric antibiotics, optimizing patient care.
* Physician order specifying the test.* Identification of the isolated microorganism.* Detailed report of the beta-lactamase test results, including methodology used.* Relevant patient demographics and clinical information.
** Various methods exist for beta-lactamase detection (e.g., iodometric, acidometric, chromogenic substrates).The specific method used may not be reflected in the code. Always ensure proper documentation of the method and results for accurate billing and clinical interpretation.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: Information not provided. RVUs are subject to change based on location and payer.
- Global Days : Not applicable.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule : Information not available. Consult payer-specific fee schedules and relevant historical data.
- Specialties:Clinical Microbiology, Infectious Disease, Pathology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Laboratory