Summary & Overview
CPT 87081: Targeted Single-Organism Culture
CPT code 87081 denotes a targeted laboratory culture where a specimen is inoculated onto a medium designed to grow only a specific pathogenic organism. This procedure is central to precise microbiologic diagnosis, infection control, and targeted antimicrobial therapy, making it significant across clinical laboratories nationwide. The code represents a focused diagnostic test that supports rapid identification of certain pathogens and can influence treatment selection and public health surveillance.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national-level overview of the clinical context for CPT code 87081, how the service is typically delivered in laboratory settings, and what stakeholders should understand about its use. The publication outlines benchmark payment considerations, common billing modifiers (listed separately), and policy or coding guidance changes where applicable. It also provides practical context for laboratory managers, coding professionals, and health system administrators about when a targeted single-organism culture is appropriate and how it fits within broader microbiology testing strategies.
Data not available in the input for payer-specific rates, associated taxonomies, and ICD-10 mappings. The report focuses on clinical description, service setting, and coding context for national audiences rather than state-level specifics.
Billing Code Overview
CPT code 87081 describes a laboratory procedure in which the lab analyst cultures a patient specimen on a test medium formulated to grow only a specific pathogenic organism. This service is a targeted culture aimed at isolating a single suspected pathogen rather than broad-spectrum or mixed-organism cultures.
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Service type: Laboratory culture focused on a single pathogenic organism
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Typical site of service: Clinical laboratory or hospital laboratory where microbiology cultures are performed
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A patient presents to an outpatient clinic or emergency department with signs and symptoms suggestive of infection caused by a specific pathogen (for example, suspected Group A Streptococcus pharyngitis, Clostridioides difficile colitis, or Neisseria gonorrhoeae infection). A clinician collects an appropriate specimen (throat swab, stool, urethral/cervical swab) and sends it to the laboratory with an order to culture on a selective medium designed to grow only the suspected organism. In the clinical workflow the specimen is received at the microbiology laboratory, logged, and plated onto the selective culture medium. The lab analyst incubates and monitors the culture for growth consistent with the target organism, performs identification tests if growth occurs, and reports results to the ordering provider for targeted therapy decisions. Typical sites of service include outpatient clinics, urgent care centers, hospital outpatient laboratories, and hospital inpatient laboratories. Equipment and supplies are limited to selective media and standard microbiology incubators; turnaround time varies from overnight to several days depending on organism and confirmatory testing needs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When a physician or qualified provider performs the professional component (interpretation) separate from the facility's technical work |