Clostridium difficile Toxin/GDH with Reflex to PCR
Test code: 91664
CPT code(s): 87449, 87324
Clinical Significance: After treatment with antibiotics, many patients develop gastrointestinal problems ranging from mild diarrhea to severe pseudomembranous colitis. This organism is an opportunistic anaerobic bacterium that grows in the intestine once the normal flora has been altered by the antibiotic. For diagnosis of toxigenic C. difficile, current practice guidelines from the CDC recommend confirmation by Nucleic Acid Amplification Testing (NAAT) if the glutamate dehydrogenase of C. difficile (GDH) Antigen is positive, and toxin is not detected by Enzyme immunoassay. Additionally, if toxin is detected without the presence of GDH antigen, confirmation by NAAT is also recommended.
Includes: If GDH Antigen is detected and Toxin A and B are not detected, then Clostridium difficile Toxin B, Qualitative, Real-Time PCR will be performed at an additional charge (CPT code(s): 87493).
or
If GDH Antigen is not detected and Toxin A and B are detected, then Clostridium difficile Toxin B, Qualitative, Real-Time PCR will be performed at an additional charge (CPT code(s): 87493).
Methodology: Immunoassay (IA)
Supply: #F57 Stool Container with Red Lid or #U02 90mL Sterile w/ Green Lid
Preferred specimen(s): 5 grams or 5 mL unformed stool
Minimum volume: 1 gram or 1 mL
Collection Instructions: Collect fresh stool in sterile, leak-proof container without media, preservative, or metal ion. For patients requiring the use of diapers, first line the diaper with clean plastic to prevent absorption. Then transfer 5 grams or 5 mL of the stool specimen from the plastic lined diaper to the sterile container.
Do not submit the diaper itself. Cap securely. Do not use any preservative, media or additive.
Transport container: Sterile Leak-Proof Container
Transport temperature: Refrigerated (Do not send frozen)
Specimen stability: Refrigerated: 5 days (72 hours)
Reject criteria:
- Formed stool
- Stool submitted in transport media or swab
- Rectal swab
- Unfrozen stool greater than 72 hours old
- Stool specimen received at room temperature.
For additional supply or collection information, please contact DLO's Customer Service at (800) 891-2917, option 2.
The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed.