2025 CPT code 87187
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Microbiology Procedures Pathology and Laboratory Procedures Feed
Minimum lethal concentration (MLC) testing for an antimicrobial agent on a specific culture isolate; performed in addition to an MIC test.
Modifiers 59 (distinct procedural service) and 91 (repeat test) may be applicable depending on the circumstances.
Medical necessity for MLC testing is established when the physician needs precise antibiotic dosing to ensure bacterial eradication, particularly in critical infections or when dealing with resistant organisms.The MLC test provides a more accurate measure of antibiotic efficacy compared to MIC alone, ensuring effective therapy.
Clinical laboratories perform this test based on physician orders.The physician interprets the results to guide antibiotic therapy.
In simple words: The lab tests how much of a specific antibiotic is needed to kill bacteria from a patient's infection. This test helps doctors choose the right amount of antibiotic to give the patient.
This CPT code, 87187, represents the laboratory procedure to determine the minimum lethal concentration (MLC), also known as the minimum bactericidal concentration (MBC), of an antimicrobial agent against a specific organism isolated from a patient's culture.The MLC is the lowest concentration of an antimicrobial agent that kills the organism, as opposed to merely inhibiting its growth. This test is performed after a minimum inhibitory concentration (MIC) test (CPT codes 87186 or 87188), using the MIC result as the starting inoculum. The procedure typically involves subculturing the last clear MIC tube onto an agar plate, assessing growth, and performing serial dilutions to identify the lowest concentration yielding no bacterial growth. Each plate represents one unit of 87187.This test aids in selecting an appropriate antibiotic dosage and is often used in critical infections like bacteremia and endocarditis.
Example 1: A patient presents with suspected bacteremia. Blood cultures are obtained, and the isolated organism undergoes MIC testing (87186).Following this, MLC testing (87187) is performed to determine the bactericidal concentration of various antibiotics for optimal treatment., A patient with suspected infective endocarditis has positive blood cultures.The laboratory performs MIC (87186) and subsequently MLC (87187) testing to guide antibiotic selection for this critical infection, ensuring adequate bacterial eradication., A patient with a resistant organism identified in a wound culture requires precise antibiotic dosing. MIC (87188) and MLC (87187) testing is done to guide therapy, optimizing treatment effectiveness while minimizing toxicity.
* Physician order specifying MLC testing.* Identification of the isolated organism.* Results of the preceding MIC test (87186 or 87188).* Detailed methodology used for MLC determination.* Specific antimicrobial agents tested.* MLC results for each antimicrobial agent tested.* Interpretation of results by a qualified laboratory professional.
** This add-on code should only be reported with a primary code for MIC testing (87186 or 87188).Payers may have specific coverage policies regarding MLC testing; check payer guidelines for local coverage determination.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: The relative value units (RVUs) for this code are not provided in the source but can be found via CMS resources and vary by location and payer.
- Global Days : Not applicable; this is a laboratory test, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable for this laboratory test.
- Fee Schedule : Historical fee schedules are not included in the provided text but are available through payer-specific resources and may vary based on geographic location and year.
- Specialties:Clinical Microbiology, Infectious Disease, Pathology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Laboratory