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HelpTest Code ACUL/AFSM Culture, Acid-Fast Bacilli (AFB)
Additional Codes
Epic Code
LAB877/LAB266
Methodology
Broth and Solid Media Primary Culture With Identification by
Biochemical and/or Molecular Method
NOTE: Mycobacterium tuberculosis complex PCR with Rifampin resistance gene detection will be performed on all AFB sputum and expectorated sputum specimens. Testing will be ordered by the laboratory. All other sources (BAL, Body Fluid, Tissue etc...) require a send-out order if needed. Mayo test code MTBRP Mycobacterium tuberculosis Complex, Molecular Detection, PCR
Includes AFB culture and AFB stain. Positive cultures will be
identified to species, and susceptibility testing will be performed
by a reference laboratory on the first isolate for each
patient.
Performing Laboratory
Bronson Laboratory Services-Microbiology
Specimen Requirements
Specimen source, patient’s age, and time of
collection are required.
Causes for Rejection: 24-Hour sputum
collection, tissue submitted in formalin, or 24-hour urine
collection
Specimen Type: Sputum; expectorated or induced;
first-morning
Container/Tube: Sterile screw-capped
container
Specimen Volume: Entire collection
Collection Instructions:
1. Patient should rinse mouth with water before
collection.
2. Label container with patient’s full
name, date of birth, date and time of collection, and source
of specimen.
Additional Information:
1. For patients who cannot produce expectorated sputum, an
induced sputum collection should be ordered from Respiratory Care
Department or bronchoscopy may be performed.
2. Gastric aspirate may be collected in children.
Specimen Type: Bronchoscopy fluid
Container/Tube: Sterile screw-capped
container
Specimen Volume: Entire collection
Collection Instructions: Label container
with patient’s full name, date of birth, date and time of
collection, and source of specimen.
Additional Information: Three negative
respiratory specimens collected on different days are normally
required to rule out pulmonary tuberculosis.
Specimen Type: Body fluid, fresh tissue, or
spinal fluid
Container/Tube: Sterile screw-capped
container
Specimen Volume: Entire collection
Collection Instructions: Label container
with patient’s full name, date of birth, date and time of
collection, and source of specimen.
Specimen Type: Urine;
first-morning, random
Container/Tube: Sterile screw-capped
container
Specimen Volume: Entire collection. 20-50 mL
Collection Instructions: Label container with
patient’s full name, date of birth, date and time of
collection, and source of specimen.
NOTE: Testing for this source is performed at Mayo Medical Laboratories. Order MIMAY Code SAFB for smear and Code CTB for culture.
Specimen Type: Gastric washing
Container/Tube: Sterile screw-capped
container
Specimen Volume: Entire collection
Collection Instructions: Label container
with patient’s full name, date of birth, date and time of
collection, and source of specimen.
Specimen Transport Temperature
Refrigerate 72 hours/Ambient 2 hours OK
Reference Values
Normal finding: no AFB recovered
MTBRIF: Mycobacterium tuberculosis complex Not Detected
Abnormal finding: AFB recovered
MTBRIF: Mycobacterium tuberculosis complex Not Detected (Rifampin resistance gene only reported if M.tb cplx is detected).
or
MTBRIF: Mycobacterium tuberculosis complex Detected/ Rifampin resistance gene Detected/Not Detected.
Critical value (automatic call-back): any positives
Day(s) Test Set Up
Monday through Sunday
Performed once a day
Test Classification and CPT Coding
87116-AFB culture
87206-AFB stain
87556-MTBRIF
87798-MTBRIF
Additional Ordering Notes
For Mycobacterial Culture Blood. Order MIMAY-;CTBBL
Specimen Type: Whole Blood
Specimen Required
Preferred: Green Top (sodium or lithium heparin)
Acceptable: SPS/Isolator System
Specimen Volume: 8-10 ml per culture
Collection Instructions:
Please note when sending SPS tube, it must be clearly labeled SPS. If label is obscured, sample may be canceled, as ACD (yellow top) is not an acceptable tube type