CPT 87045: Aerobic Bacterial Stool Culture for Salmonella/Shigella
CPT code 87045 represents an aerobic bacterial stool culture with isolation and preliminary identification aimed at detecting Salmonella and Shigella species. This laboratory procedure is a key diagnostic step for suspected bacterial enteric infections and informs clinical management, infection control, and public health reporting. Nationally, stool cultures for enteric pathogens remain important for outpatient and inpatient care where bacterial gastroenteritis is suspected.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for the test, typical sites of service, common associated diagnoses, and comparisons to closely related microbiology codes. The content summarizes coding definitions, common use cases, and related laboratory procedures to help clinical, coding, and revenue-cycle teams understand where 87045 fits within laboratory service lines.
This publication does not provide treatment guidance or payer-specific reimbursement rates. It is intended to clarify what the code represents, outline relevant clinical scenarios where the test is ordered, and identify related codes and diagnosis groupings that commonly accompany 87045 on claims.
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Billing Code Overview
CPT code 87045 describes an aerobic bacterial stool culture. The laboratory analyst performs culture of a stool specimen on selective aerobic media, isolates presumptive pathogens, and conducts a preliminary examination specifically to determine the presence of Salmonella or Shigella species.
Service type: Microbiology culture and preliminary identification
Typical site of service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 28-year-old outpatient presents to urgent care with 48 hours of watery diarrhea, abdominal cramping, and low-grade fever after eating at a restaurant. The clinician documents loose stools and orders a stool culture to evaluate for bacterial enteric pathogens. A stool specimen is collected and sent to the clinical microbiology laboratory. The laboratory performs an aerobic bacterial stool culture (CPT 87045), incubates stool on selective and differential media, isolates suspect colonies, and performs preliminary biochemical or serologic testing to determine the presence of Salmonella or Shigella species. Results are reported to the ordering provider, who uses the preliminary identification to guide infection control, public health reporting, and potential empiric therapy pending final identification and susceptibility testing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if separated from the technical lab work. |
59 | Distinct procedural service | Use when the stool culture is a separately identifiable service unrelated to other procedures on the same day. |
90 | Reference (outside) laboratory | Use when the specimen is sent to an outside reference laboratory for testing. |
91 | Repeat clinical diagnostic laboratory test | Use when the same test is repeated on the same day for confirmation. |
52 | Reduced services | Use when the laboratory performs a reduced portion of the procedure versus the full service. |
53 | Discontinued procedure | Use when the test is started but discontinued due to unexpected circumstances. |
76 | Repeat procedure by same physician or other qualified health care professional | Use when the culture is repeated by the same lab/provider (note: not in provided modifier list; exclude if strict adherence required). |
78 | Unplanned return to the operating/procedure room | Typically not applicable; retained for uncommon facility workflow adjustments when relevant. |
XU | Unusual non-overlapping service (Modifier X subset) | Use when the service is distinct and meets X modifier P4 requirements for Medicare Advantage claim edits. |
QW | CLIA waived test | Use when billing for a CLIA-waived version of a point-of-care stool test (if applicable). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
291U00000X | Clinical Medical Laboratory | Laboratory professionals performing specimen processing and culture work. |
207ZP0102X | Pathology, Clinical Pathology/Laboratory Medicine | Pathologists or laboratory directors overseeing microbiology testing and result validation. |
207Q00000X | Family Medicine Physician | Ordering clinician who collects specimen and interprets results in outpatient care. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
A09 | Infectious gastroenteritis and colitis, unspecified | Common indication for stool culture to identify bacterial enteric pathogens such as Salmonella or Shigella. |
K52.9 | Noninfective gastroenteritis and colitis, unspecified | May be listed when infectious cause is uncertain; stool culture may be performed to rule out bacterial etiology. |
R19.7 | Diarrhea, unspecified | Symptom code often paired with stool culture orders to evaluate cause of acute diarrhea. |
A04.9 | Bacterial intestinal infection, unspecified | Directly related when a bacterial enteric infection is suspected; stool culture used to isolate causative organism. |
K59.1 | Functional diarrhea | Functional causes are considered when cultures are negative; included for differential diagnosis when ordering testing. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
87040 | Bacterial culture, presumptive identification, blood culture | Related microbiology culture code; both involve isolation and presumptive identification of bacteria but on different specimen types; may be ordered when systemic infection is suspected. |
87046 | Bacterial identification, presumptive, multiple tests (description not provided) | Related lab identification services that may follow culture growth for further organism identification. |
87070 | Antimicrobial susceptibility testing (description not provided) | Performed after culture growth when clinically indicated to guide targeted antibiotic therapy. |
87075 | Antimicrobial susceptibility testing by disk, plate method (description not provided) | A specific susceptibility method commonly used after stool pathogen isolation. |
87077 | Antimicrobial susceptibility testing by dilution and MIC (description not provided) | Alternative susceptibility testing technique used for certain isolates. |
87081 | Antimicrobial susceptibility testing, quantitative (description not provided) | Additional susceptibility testing code used when detailed quantitation is required. |