Biopsy Culture, Mycobacterium

CPT CODE: 87015, 87116, 87206 (smear)

Test includes culture and acid-fast stain (if specimen volume is adequate). Culture includes decontamination and concentration, if appropriate (i.e. specimen potentially contaminated with normal flora). If a mycobacterial species is isolated, the organism will be identified. Susceptibility testing will be performed depending upon the isolate identification. Other isolated organisms (i.e. aerobes, yeast, etc.) may be referred for identification and/or susceptibility testing if medically indicated AND a separate culture procedure has NOT yielded the same organism(s).

DAYS PERFORMED: Daily, 24 hours.
TURNAROUND TIME: Smear results, 24 hours after receipt of the specimen in the laboratory. Preliminary reports are available after 1 week or when a mycobacterial isolate is detected. Negative cultures with negative smears will be issued after 8 weeks. Negative cultures with positive smears will be issued after 12 weeks. Completion of culture reports may require additional time when mycobacteria are isolated and/or susceptibility testing is performed.
SPECIAL INSTRUCTIONS: The specific anatomic site of the biopsy MUST be specified on the order or requisition with surface and/or deep or surgical biopsies delineated.
CONTAINER TYPE: Sealed sterile container, no preservative
COLLECTION: Specimens are to be collected from a site prepared utilizing aseptic technique. Overlying and adjacent areas must be carefully prepared to eliminate surface organisms. Ideally, material is obtained by needle aspiration through intact surface, which has been cleaned with antiseptic, and injected into a sealed, sterile container. Sampling of open lesions is enhanced by deep aspiration using a sterile plastic catheter. If irrigation is necessary, nonbacteriostatic sterile saline may be used. Pulmonary samples may be obtained by transtracheal percutaneous needle aspiration. Optimal isolation of mycobacteria from tissue is accomplished by processing as much tissue as possible.
SPECIMEN REQUIREMENTS: Surgical tissue, biopsy material from normally sterile site
REJECTION CRITERIA: Inappropriate specimen container, insufficient specimen volume, specimen received in a preservative. Only three specimens per body site with negative acid-fast smears will be processed. Subsequent specimens will be rejected. Specimens from known positive patients will be accepted only once a week for culture and smear per body site.
MINIMUM VOLUME: 0.5-10 mL or a small piece of tissue
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate.
REFERENCE RANGE: No acid-fast bacilli observed on smear or isolated in culture.
LIMITATIONS OF TEST: A single negative smear does not rule out the presence of mycobacterial infection.
METHODOLOGY: Acid-fast smear: fluorochrome stain. Culture: inoculation of conventional culture media and a rapid medium for automated continuous analysis.


DNA probes may be incorporated to aid with more rapid identification of mycobacterial isolates. This will generate an additional charge(s). Susceptibility testing will be performed only on the first Mycobacterium isolate from each specimen type per patient. Additional susceptibilities may be performed after a period of 4 weeks for patients with suspected treatment failure. Susceptibility testing is performed routinely only for M. tuberculosis complex, Susceptibility testing for other Mycobacterium species is performed by special request only. The battery of drugs routinely tested will vary by isolate and/or physician request. Patients from whom M. tuberculosis is isolated in culture are reported to the City of Chicago Board of Health. This is mandated by law.



TEST SYNONYM(S):AFB Culture, Biopsy; Biopsy AFB Culture; Mycobacterium Culture, Biopsy; TB Culture, Biopsy