Urine Culture No Longer a Family PACT Benefit for Oct. 2013
October 30, 2013Effective for dates of service on or after November 1, 2013, CPT code 87086 (culture, bacterial; quantitative colony count, urine) is no longer a benefit of the Family PACT Program.
The following susceptibility tests, when performed as a reflex test from a positive 87086, are not reimbursable:
|
HCPCS Code |
Description |
|
87181 |
Susceptibility studies, antimicrobial agent; agar diffusion method, per agent |
|
87184 |
Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer disks) |
|
87186 |
Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [MIC] or breakpoint), each multi-antimicrobial, per plate |
These susceptibility tests, however, will remain reimbursable when performed as a reflex test from a positive CPT code 87081 (culture, presumptive, pathogenic organisms, screening only) for the following diagnosis codes:
|
S-Code |
Description |
|
S3032 |
Infection at insertion/removal site |
|
S7033 |
Female Sterilization-Operative site infection (within 30 days postoperative) |
|
S8032 |
Vasectomy-Acute infection at operative site (within 30 days postoperative) |