Summary & Overview
CPT 87076: Definitive Identification of Anaerobic Isolate
CPT code 87076 designates additional laboratory procedures performed to definitively identify a presumptively identified anaerobic isolate, often to the species level. Accurate anaerobic identification supports targeted antimicrobial therapy, infection control, and public health surveillance, making this code relevant across hospitals, clinical laboratories, and reference testing networks nationwide. Key national payers evaluated include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical role of the service, common billing and coding context, and what to expect in payer coverage patterns and reimbursement benchmarks. The publication outlines the procedural scope of 87076, explains typical sites of service (hospital and reference microbiology laboratories), and highlights the operational and clinical implications of definitive anaerobic identification. It also summarizes coverage considerations and typical modifiers in use. Where specific payer policies or national benchmarks are unavailable, the report flags data gaps as "Data not available in the input." The content is intended for laboratory managers, billing specialists, and policy analysts seeking a concise national summary of the code's purpose, clinical relevance, and reimbursement context.
Billing Code Overview
CPT code 87076 describes additional laboratory testing performed by a lab analyst on a presumptively identified anaerobic isolate to provide definitive identification, often to the species level. This service involves specialized microbiology methods that go beyond initial presumptive tests to characterize anaerobic organisms more specifically.
-
Service type: Microbiology identification / confirmatory organism identification
-
Typical site of service: Clinical laboratory, hospital microbiology laboratory, or reference laboratory
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 62-year-old inpatient with a recent abdominal abscess undergoes drainage and culture. Initial anaerobic culture growth yields a presumptive anaerobic organism on basic phenotypic tests. The clinical microbiology laboratory performs 87076 when the lab analyst proceeds to additional, definitive testing—such as biochemical panels, automated identification systems, MALDI-TOF confirmation, or targeted molecular assays—to identify the anaerobic isolate to the species level. Typical workflow: specimen receipt and anaerobic culture setup, preliminary Gram stain and colony morphology assessment, presumptive identification (e.g., Bacteroides spp.), followed by performance of 87076 for definitive species identification to guide targeted antimicrobial therapy. Typical site of service is the hospital clinical microbiology laboratory or a reference laboratory receiving isolates from inpatient or outpatient settings. Common scenario modifiers include professional or technical component reporting when identification involves laboratory instrumentation or reference lab interpretation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the professional component (interpretation) is billed separate from technical processing. |