Overview
CPT® Code 87086 is used to report a quantitative urine culture to identify and count bacterial colonies, aiding in the diagnosis and management of urinary tract infections (UTIs). This test provides information about bacterial growth levels and types of organisms, allowing clinicians to determine infection severity and guide appropriate antimicrobial therapy.
CPT 87086 represents the laboratory culture procedure. Interpretation, patient counseling, and follow-up care are billed separately.
Key Facts About CPT® 87086
- Service type: Clinical microbiology laboratory test
- Provider type: Physicians, laboratories, and qualified healthcare professionals
- Medical services included:
- Quantitative culture of urine specimen
- Identification of bacterial species and colony counts
- Reporting results with interpretation-ready data
- Specimen type: Urine (clean catch or catheterized)
- Common clinical indications:
- Diagnosis of suspected urinary tract infections
- Monitoring recurrent or complicated UTIs
- Guiding antibiotic therapy based on bacterial colony counts
- Evaluating asymptomatic bacteriuria in high-risk patients
When to Use CPT® 87086
CPT 87086 is appropriate when:
- A urine specimen is collected for quantitative bacterial culture
- The test is medically necessary to diagnose, monitor, or manage urinary infections
- Results will influence treatment decisions, such as antibiotic selection or therapy duration
Examples:
- Urine culture for a patient presenting with dysuria, frequency, and urgency
- Monitoring bacterial load in a patient with recurrent UTIs
- Screening asymptomatic pregnant patients at risk of bacteriuria
- Guiding treatment in patients with catheter-associated urinary infections
Documentation Requirements
To properly support CPT 87086 billing, documentation should include:
- Patient identifiers and date of specimen collection
- Clinical indication for urine culture
- Specimen type and method of collection
- Laboratory results including colony count and identified organisms
- Follow-up treatment or antibiotic management plan
Comprehensive documentation ensures compliance, accurate reimbursement, and longitudinal tracking of urinary infections.
Reimbursement and Coding Considerations
- CPT 87086 is generally covered by Medicare, Medicaid, and commercial insurers when medically necessary
- Interpretation and patient counseling are billed separately
- Modifier use may be required if multiple cultures are performed simultaneously
- Always verify payer-specific rules for urinary culture testing and bundled services
How OptiMantra Supports Urinary Culture Testing
OptiMantra’s integrated EMR and practice management platform streamlines documentation, tracking, and billing for quantitative urine cultures like CPT 87086.
With OptiMantra, providers can:
- Link urine culture orders directly to the patient chart
- Track bacterial identification results over time
- Document clinical indications, test results, and follow-up plans using structured templates
- Generate billing codes for laboratory services
- Integrate culture results into broader patient care plans, including antimicrobial therapy management
By centralizing lab tracking, documentation, and billing, OptiMantra ensures accuracy, compliance, and smooth workflow for urinary infection management.
Try OptiMantra for free here!
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