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ACID FAST CULTURE (AFB), Non-sterile sources: (088-0005)
Clinical Indication:

 Cultivation of Mycobacterium spp. from non-sterile sources; Mycobacterium tuberculosis or other Mycobacteria spp. suspected.
Test Mnemonic:

 C ACON
Methodology:

Acid fast smear, culture for the isolation and identification of Mycobacterium species and antimicrobial susceptibility testing when appropriate
Performed:

 Clinical Microbiology
Turnaround Time:

 Samples are processed 5 days per week. Smear is reported the day of processing; positive cultures are reported when growth and negative cultures are held 6 weeks.
Specimen Requirements: Patient Preparation: Productive cough

Collect: Collect specimens in a sterile, leak-proof container. For sputum collection, use the sputum collection kit. Collection complete first morning urine for AFB culture.

Specimens for testing: Sputum, respiratory sources, gastric aspirates, feces, autopsy sources, abscesses, skin lesions, urine samples. Swabs are not recommended for optimal recovery of AFB.

Specimen Preparation: Sterile containers

Storage/Transport: Refrigerate. Deliver gastric aspirates as soon as possible due to pH changes

Stability: 72 hours

Causes for Rejection: More than three samples per week submitted on the same patient (respiratory sources only), feces on patients other than HIV+, leaking container, insufficient quantity, samples submitted on a swab, more than two feces per week.
Clinical Information:

 
Reference Range:

No Acid-fast bacilli isolated
Note:

Test includes: Acid fast smear, isolation and identification of Mycobacterium species and antimicrobial susceptibility testing when appropriate

It is recommended to collect sputum samples 24 hours apart and the first morning urine for optimal recovery. The first positive smear from respiratory sources with AFB is considered a critical value.
CPT 4 Code:

 87116 - culture, 87206 - smear, 87015 - concentration
Review 2/27/2013 by Theresa Friloux

When ordering tests for which Medicare or Medicaid reimbursement will be sought, physicians should only order tests that are medically necessary for the diagnosis or treatment of the patient.  Components of the organ or disease panels may be ordered individually.  The diagnostic information must substantiate all tests ordered and must be in the form of an ICD-9 code or its verbal equivalent.

 

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