Summary & Overview
CPT 87070: Aerobic Culture with Isolation and Presumptive Identification
CPT code 87070 represents an aerobic bacterial culture with isolation and presumptive identification of isolates from clinical specimens excluding urine, blood, and stool. This laboratory service is a fundamental diagnostic step in identifying bacterial pathogens from wound, respiratory, or other non-sterile body site specimens and supports antimicrobial decision-making and infection control efforts nationwide. The code matters because accurate identification of pathogens underpins clinical management, public health surveillance, and laboratory reimbursement frameworks.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for CPT code 87070, the typical sites of service where it is performed, and how it relates to adjacent laboratory codes such as urine culture and susceptibility testing. The publication provides benchmarks and coding relationships relevant to billing and claims adjudication, notes common clinical indications for ordering the test, and highlights related laboratory services used in diagnostic workflows. Policy, billing, and clinical audiences will gain a clear reference for where 87070 fits within microbiology service lines and claim submissions.
Data not available in the input that may be relevant for some audiences includes payer-specific reimbursement rates and regional utilization metrics.
Billing Code Overview
CPT code 87070 describes a laboratory aerobic culture with isolation and presumptive identification of organisms from clinical specimens other than urine, blood, or stool. The service involves the technical laboratory steps to culture a specimen in the presence of oxygen, isolate the organism present, and perform analysis of the isolate for a presumptive identification.
Service type: Microbiology laboratory culture — aerobic culture with organism isolation and presumptive ID
Typical site of service: Clinical laboratory or hospital laboratory performing microbiology culture services
Clinical & Coding Specifications
Clinical Context
A 28-year-old patient presents to a family medicine clinic with a painful, fluctuant skin lesion on the forearm and low-grade fever. The clinician performs a point-of-care evaluation, incises and drains the abscess, and submits a wound swab or tissue specimen to the clinical laboratory for culture. The laboratory performs aerobic culture of the specimen (excluding urine, blood, or stool), isolates any bacterial growth, and carries out presumptive identification of the isolate to guide initial antibiotic selection. Typical workflow: specimen collection in clinic, transport to a Clinical Medical Laboratory or hospital microbiology lab, plating on appropriate aerobic media, incubation, isolation of colonies, and preliminary identification (e.g., colony morphology, basic biochemical tests or automated system presumptive ID). Results are reported back to the ordering provider (e.g., Family Medicine Physician) to inform therapy; further testing (e.g., susceptibility testing) may be performed separately if requested.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When a physician reports only the professional component of a diagnostic laboratory service if applicable |
59 | Distinct procedural service | When the culture is performed and is distinct from other services on the same day |
76 | Data not provided in input | Data not available in the input. |
91 | Repeat clinical laboratory test | When the same culture test is repeated on the same day for verification |
90 | Reference (outside) laboratory | When the specimen is sent to an outside/reference lab for testing |
95 | Synchronous telemedicine service rendered via realtime interactive audio and video | Not typically used for lab CPTs; include for documentation of remote services if applicable |
52 | Reduced services | When full laboratory procedure is partially reduced or not completed |
59 | Distinct procedural service | Use when another procedure on the same day is unrelated and the culture must be billed separately |
91 | Repeat clinical laboratory test | Use when repeat testing performed for the same specimen or patient |
90 | Reference (outside) laboratory | Use when an outside lab performed the culture |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
291U00000X | Clinical Medical Laboratory | Primary performing facility/provider taxonomy for laboratory personnel |
207ZP0102X | Pathology, Clinical Pathology/Laboratory Medicine | Specialty for microbiology directors and lab pathologists overseeing testing |
207Q00000X | Family Medicine Physician | Common ordering provider for outpatient wound or throat cultures |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
J02.9 | Acute pharyngitis, unspecified | Throat swab cultures (non-urine/blood/stool) may be performed to identify causative bacteria in acute pharyngitis |
J03.90 | Acute tonsillitis, unspecified | Culture of throat/tonsillar swab helps isolate organisms in tonsillitis when indicated |
L02.91 | Cutaneous abscess, unspecified | Wound or abscess specimens are common non-urine/non-blood sources for aerobic bacterial culture and isolation |
N39.0 | Urinary tract infection, site not specified | Included in differential but urine-specific culture codes exist; 87070 is not used for urine |
R50.9 | Fever, unspecified | When fever of unclear source prompts culture of non-blood, non-urine specimens to identify an infectious source |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
87086 | Culture, bacterial; quantitative, urine | Alternative culture code specific to urine specimens; not used for non-urine sources |
87088 | Culture, bacterial; with isolation and presumptive identification of isolates, urine | Urine-specific counterpart for isolation/presumptive ID services |
87186 | Susceptibility studies, antimicrobial agent; microdilution or agar dilution | May be ordered after presumptive identification to determine antibiotic susceptibility |
87205 | Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types | Often performed on the primary specimen or direct smear to provide rapid, preliminary information before culture results |