Bronchoscopy Culture and Gram Stain
Test Mnemonic
BALCSM
CPT Codes
- 87071 - QTY (1)
- 87205 - QTY (1)
LOINC ®
43441-5
Aliases
- BAL culture
- Lower Respiratory Culture
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| Unspecified | Brushing (s), bronch | Sterile container | Refrigerated | Refrigerated | Protected brush specimen |
| Unspecified | Bronch (BAL) | Sterile container | Refrigerated | Refrigerated | Bronchoalveolar lavage only |
Stability
| Environmental Condition | Description |
|---|---|
| Ambient | Unacceptable |
| Refrigerated | 24 hours |
| Frozen | Unacceptable |
Days Performed
Sun - Sat
Turnaround Time
7 days
Methodology
| Name | Description |
|---|---|
| Culture, Identification | |
| Gram Stain |
Reference Range
Special Info
Quantitative culture for the recovery of aerobic bacteria is performed on respiratory specimens collected during bronchoscopy. Separate test orders are required to rule out the presence of mycobacteria, fungi, viruses, and atypical bacterial pathogens in respiratory specimens. Blood cultures are recommended for patients being evaluated for pneumonia. If culture is positive, identification will be performed on clinically significant organisms at an additional charge. Identification CPT codes that may apply include: 87206, 87077, 87106, 87107, 87153, 87158. Antimicrobial susceptibilities are performed when indicated, and the following CPT codes may apply: 87181, 87184, 87185, 87186.
Clinical Info
Distinguishing colonizing organisms from pathogens can be difficult. Susceptibility testing is performed on potential pathogens in amounts considered significant (1,000 cfu/ml in protected brush samples, 10,000 cfu/ml in bronchoalveolar lavage samples, pure culture, or predominance on Gram stain). Correlation of culture results with clinical findings is essential.