Medical Necessity Documentation:
Client Notes:
Please contact Microbiology at 266-1500 (Option 1) if susceptibility studies are needed. Susceptibilities must be requested for organisms other than M. tuberculosis
Patient Preparation:
Specimen Requirements:
Preferred Specimen(s):
10.0 mL of body fluids (lower respiratory tract specimens, or gastric lavage) in sterile container
or
2.0 mL CSF
or
40.0 mL urine in sterile, leak-proof container
or
2 grams fresh (unfixed) tissue in sterile container
or
1 mL exudate, aspirate, lesion material, ocular specimen collected in a sterile, leak-proof container
or
1 gram or 1 mL stool collected in a sterile leak-proof container
Minimum Volume:
2 mL of body fluids, lower respiratory tract specimens, or gastric lavage in sterile container
or
2 mL (min .5mL) gastric lavage in sterile container
or
1 mL CSF
or
1 gram fresh tissue (unfixed)
or
20 mL urine
or
1 mL or 1 swab wound, exudates, aspirates, lesion material, or ocular specimens
Collection Instructions:
Tissue and biopsy material: Sterile, leak-proof container with small amount of saline, no fixative or preservative
Gastric lavage fluid: Sterile, leak-proof container. Must be neutralized with sodium bicarbonate within 4 hours of collection. (minumum 0.5mL)
Expectorated Sputums Instruct patient to gargle with water and cough deeply. May be collected in sputum collection device per instructions. (First AM, deep cough specimens are best).
Three separate early morning collections on at least 8 TO 24 HOURS apart three consecutive days are recommended.and to include at least one early morning specimen
Urine should be first/early AM collection
Swab specimens are not recommended.
For patient collection instruction sheet on Expectorated Sputum Collection see
Addendum D
For Spanish patient collection instruction sheet on Expectorated Sputum Collection see
Addendum D
For Burmese patient collection instruction sheet on Expectorated Sputum Collection see
Addendum D
For Arabic patient collection instruction sheet on Expectorated Sputum Collection see
Addendum D
Transport & Storage: Temperature/Stability:
Unacceptable Ambient
5 days Refrigerated (Transport cold packs)
Unaccetable Frozen
Rejection Criteria:
24 hour pooled urine or sputum, dry swabs, specimens received in alcohol, formalin, EDTA, lithium heparin or conventional blood culture bottles, throat/oral/sputum swabs from non-cystic fibrosis patients, urine specimens in preservative tubes
Reference Range:
See Laboratory Report
Critical Ranges:
Test Comments:
Mycobacteria Culture, Concentration, Acid-Fast Bacilli Stain
An additional charge for Concentration (CPT code(s): 87015) will be added as appropriate.
Identification will be performed at an additional charge for each organism
CPT code(s) 87118: Matrix Assisted Laser Desorption/Ionization-Time of Flight or
CPT code(s) 87153: AFB Sequencing
Methodology:
Continuous Monitoring Broth Cult System & Conventional Culture • Microscopic Exam w/ Fluorochrome St
Clinical Significance:
Mycobacteria, Culture, with Fluorochrome Smear - There are more than 70 species of mycobacteria of which the primary pathogen is M. tuberculosis. Tuberculosis is a chronic, granulomatous disease caused by M. tuberculosis. Identification, and, if appropriate, antibiotic sensitivity, is required to initiate necessary therapy
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Turn Around Time:
Smear 24 hrs w/in receipt of lab, Cult 6-8 weeks
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Regional Medical Center, Quest - Chantilly
PHL Test Code:
CXAFB
EPIC Test Code:
LAB877
Send Out Test Code:
5202
Alternate Test Names:
Acid Fast Bacilli Culture; Acid Fast Bacillus ; Acid Fast Culture; AFB; Culture, Acid Fast Bacilli; Mycobacteria
Included Tests:
Mycobacteria culture; Concentration; Acid-Fast Bacilli stain;
Possible Identificaitons: M. tuberculosis Complex Probe; M. avium Complex Probe; M. kansasii Probe; M. gordonae Probe
CPT Coding:
87015, 87116, 87206 (Identifications as performed 87149 up to x 5, I not identified 87118 or 87153) If TB isolated 1st time or after 3 months will add 87190 per drug