Summary & Overview
CPT 87106: Definitive Identification of Yeast Isolate, Species-Level
Headline: CPT code 87106 defines definitive laboratory identification of yeast isolates, a targeted microbiology test that refines presumptive findings to the species level. Lead: CPT code 87106 covers additional testing performed by a laboratory analyst to more specifically identify a yeast organism after a presumptive result. This code matters nationally because species-level identification can affect antifungal selection, infection control decisions, and diagnostic accuracy for inpatient and outpatient care.
CPT code 87106 represents a focused microbiology identification procedure used in clinical and hospital laboratories. It is relevant to hospital systems, reference laboratories, clinicians managing fungal infections, and payers overseeing laboratory benefit policies. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context for using 87106, typical sites of service, and what this code denotes for laboratory workflows. The publication provides benchmarks where available, summarizes common billing practices, and outlines policy considerations and coding context that affect reimbursement and claims processing. Data not available in the input will be noted where applicable. The content is intended for a national audience including coding professionals, laboratory managers, and payer policy teams.
Billing Code Overview
CPT code 87106 describes laboratory work in which a lab analyst performs additional testing on a presumptively identified yeast isolate to definitively identify the organism, typically to the species level. This service is a microbiology identification procedure performed after an initial presumptive identification, providing more specific organism identification that can inform targeted clinical management.
Service type: Microbiology/Ancillary Laboratory Testing
Typical site of service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A patient presents to an outpatient infectious disease clinic with persistent funguria and recurrent urinary symptoms after initial empiric antimicrobial therapy. Urine culture grows a presumptive yeast isolate on primary media. The laboratory technologist performs initial identification (e.g., morphology, germ tube test) and forwards the isolate to the microbiology laboratory’s mycology bench for definitive species-level identification. The lab analyst conducts additional phenotypic testing (biochemical panels, carbohydrate assimilation), MALDI-TOF mass spectrometry, or molecular methods to identify the yeast to species. Results are reported to the ordering clinician to guide antifungal selection (for example, differentiating Candida albicans from Candida glabrata). Typical workflow steps: specimen receipt and verification, subculture and isolation, presumptive identification, performance of 87106 level definitive identification tests, review and validation by a laboratory director, and result reporting in the electronic medical record. Typical site of service is an outpatient clinical microbiology laboratory, hospital laboratory, or reference laboratory. Common patient scenarios include persistent or recurrent candiduria, bloodstream infection surveillance isolates forwarded for specialty ID lab work, or isolates from sterile sites requiring species-level identification for targeted therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |