CONTRACTOR INFORMATION

Contractor Name

CareFirst of Maryland, INC., Medicare Part A

Contractor Number

00190

Contractor Type

Fiscal Intermediary

ARTICLE INFORMATION

Article Database ID Number

 A23978

Article Type

General

Article Version Number

Article Title

Bacterial Culture (Screening) 

Is the AMA/CPT and ADA/CDT Copyright Statement Required?
Yes

CPT codes, descriptions and other data only are copyright 2004 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. CDT-4 codes and descriptions are Ó2004 American Dental Association. All rights reserved.

Primary Geographic Jurisdiction

Maryland

Washington, DC

Secondary Geographic Jurisdiction

Alabama, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, Washington state, and Wyoming

Article Publication Date

Article Beginning Effective Date

09/1/2004

Article Text

LCD Description

 A bacterial culture is the act or process of growing living bacteria in a prepared nutrient media.

Limitations

• The laboratory tests listed in the "HCPCS Codes" section of this policy are for bacterial screening cultures.
• Medicare's national policy does not allow coverage of screening procedures.
• When a screening culture results in an abnormal finding, the test is non-covered because the purpose of performing the test was for an excluded service.

Coding Guidelines

Reasons for Denial

• As this is a screening service, it is not reimbursable under the Medicare Program,
• The service is for screening purposes, and;
• The service does not follow the guidelines of this policy.

Coverage Topic

 Lab Services

Other Comments

Does this Article contain a "Least Costly Alternative" provision?

No

THIS BULLETIN SHOULD BE SHARED WITH ALL HEALTH CARE PRACTITIONERS AND MANAGERIAL MEMBERS OF THE PROVIDER/SUPPLIER STAFF. BULLETINS ISSUED AFTER OCTOBER 1, 1999 ARE AVAILABLE FROM OUR WEBSITE AT www.marylandmedicare.com