2025 CPT code 87186
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Microbiology Procedures Pathology and Laboratory Procedures Feed
Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [MIC] or breakpoint), each multi-antimicrobial, per plate.
Modifiers 59 and 91 are applicable as described in the coding guidelines.
Medical necessity for this test is established when a patient presents with an infection requiring antibiotic therapy, and the choice of antibiotic needs to be guided by the sensitivity profile of the infecting organism.This is particularly crucial in serious infections like bacteremia or endocarditis.The test is medically necessary to improve treatment outcomes and potentially reduce morbidity and mortality.
The clinical responsibility lies with the ordering physician who interprets the results to guide antibiotic selection and treatment of the infection.The laboratory's responsibility is to perform the technical aspects of the test, reporting the MIC values and interpreting the results as S, I, or R.
In simple words: This lab test checks how well different antibiotics work against a specific germ found in a patient's body.The lab uses special plates with different antibiotics to see which one stops the germ's growth at the lowest dose. This helps doctors choose the best antibiotic and dosage to treat the infection.
This CPT code represents susceptibility testing of a microorganism isolate against multiple antimicrobial agents using microdilution or agar dilution methods to determine the minimum inhibitory concentration (MIC) or breakpoint.The test involves inoculating a standardized concentration of the isolate onto a plate containing multiple antibiotics at various concentrations.After incubation, the lowest concentration of each antibiotic inhibiting growth is determined and reported as the MIC. Results are interpreted as susceptible (S), intermediate (I), or resistant (R) to guide antibiotic selection and dosage.
Example 1: A patient presents with suspected bacterial pneumonia.A sputum culture is obtained and the isolated organism undergoes susceptibility testing using code 87186 to determine the appropriate antibiotic regimen., A patient with suspected bloodstream infection (bacteremia) has blood cultures drawn.After identifying the organism, code 87186 is used to test the organism's sensitivity to various antibiotics to guide treatment., A patient with endocarditis (infection of the heart valves) undergoes blood culture and receives susceptibility testing using code 87186 to identify the most effective antibiotic therapy.This is crucial due to the severity of the infection.
** This test is performed in a clinical laboratory setting.The results are essential for guiding appropriate antibiotic treatment and improving patient outcomes.Ensure proper documentation to support medical necessity.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Infectious Disease, Microbiology, Pathology
- Place of Service:Laboratory