CPT 87107 Definitive Mold ID Reimbursement

CPT code 87107 covers additional laboratory testing performed on a presumptively identified mold isolate to achieve definitive organism identification, often to the species level. This code is used in clinical microbiology and reference laboratories and matters nationally because accurate fungal identification guides clinical management, infection control, and public health surveillance. Payers commonly involved in coverage decisions for this type of laboratory service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn what CPT code 87107 represents, the clinical context for ordering definitive mold identification, and the typical care setting where the service is provided. The publication summarizes national benchmarks and payer coverage considerations, highlights relevant coding and billing considerations, and provides clinical context about why species-level identification can be important for treatment and epidemiology. Data not available in the input will be noted where applicable.

Billing Code Overview

CPT code 87107 describes laboratory testing in which a lab analyst performs additional tests on a presumptively identified mold isolate to definitively identify the organism, typically to the level of species. This service represents definitive fungal identification performed after an initial presumptive identification.

Service type: Microbiology laboratory diagnostic testing — fungal identification
Typical site of service: Clinical microbiology laboratory or reference laboratory (performed on cultured mold isolates)

Clinical Context

A clinical laboratory receives a respiratory specimen from an inpatient with persistent cough and possible fungal pneumonia after initial culture yields a presumptive mold. The clinical microbiology technologist performs primary culture and preliminary identification (e.g., colony morphology, lactophenol cotton blue wet mount). For definitive identification to the species level, a lab analyst performs advanced testing such as phenotypic biochemical panels, slide culture, mass spectrometry (MALDI-TOF) confirmation, or targeted molecular sequencing. The typical workflow: physician orders fungal culture and identification; specimen is sent to the microbiology lab; presumptive mold isolate is recovered; routine tests are performed; when preliminary results are insufficient for targeted therapy or infection control, 87107 is billed for additional definitive identification. Typical site of service: hospital clinical laboratory, reference microbiology laboratory, or specialized public health lab. Typical patient scenario: hospitalized adult with immunosuppression and worsening pulmonary infiltrates where species-level identification of a mold (for example, Aspergillus species vs. Mucorales) will affect antifungal selection and epidemiologic management.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the professional (interpretive) component of the test is billed separately by the performing pathologist or laboratory professional.

Taxonomy Code	Specialty	Notes
207Q00000X	Microbiology Laboratory	Clinical microbiologists and laboratory directors who supervise fungal identification testing.
2080P0004X	Infectious Disease	Infectious disease physicians who request species-level identification for management.
207L00000X	Pathology	Pathologists overseeing laboratory testing and result interpretation.
363LP0808X	Public Health Laboratory	Reference lab specialists performing advanced fungal identification methods.
207K00000X	Medical Laboratory Technologist	Technologists performing culture and identification steps.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`B44.0`	Invasive pulmonary aspergillosis	Species-level identification distinguishes Aspergillus species for directed antifungal therapy.
`B44.9`	Aspergillosis, unspecified	Confirms the specific species when preliminary testing is inconclusive.
`B48.1`	Candidiasis of lung	Although Candida is a yeast, definitive lab identification clarifies mixed fungal infections or differentiates molds from yeasts.
`B46.9`	Zygomycosis, unspecified	Identification to species level differentiates Mucorales from other molds and impacts treatment choices.
`J18.9`	Pneumonia, unspecified organism	When a fungal etiology is suspected after initial workup, species identification is pursued to guide therapy.
`B37.88`	Other forms of candidiasis	Relevant if co-infection or initial morphologic overlap requires advanced identification techniques.
`A41.9`	Sepsis, unspecified organism	In bloodstream or disseminated infections where mold is isolated, species-level ID affects antifungal selection and prognosis.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87220`	Culture, fungal, pathogenic, any type of specimen	Often performed prior to `87107`; initial culture to recover the mold isolate for presumptive identification.
`87102`	Smear, fungal; clarity and staining for microscopic examination	Performed as an initial rapid assessment to detect fungal elements before definitive species identification.
`87471`	Infectious agent detection by nucleic acid (DNA or RNA), direct probe technique, fungal, amplified probe technique	Performed when molecular testing is used as part of definitive identification; may complement or substitute methods billed under `87107` depending on payer rules.
`87476`	Infectious agent detection by nucleic acid (DNA or RNA), direct probe technique; fungi, identification, amplified probe technique	Used for targeted molecular identification of fungal species when billed separately.
`88313`	Surgical pathology, gross and microscopic examination	Performed if tissue is submitted and histopathology with fungal stains informs identification and correlation with microbiology findings.

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Summary & Overview

CPT 87107: Definitive Identification of Mold Isolate