C. difficile Toxin/GDH w/ Reflex to PCR
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Test code: 91664
CPT code(s): 87449, 87324
Methodology: Immunoassay
Includes: If the GDH Antigen is detected and the Toxin A and B are not detected or the GDH Antigen is not detected and the Toxin A and B are detected, Clostridium difficile Toxin B, Qualitative, Real-Time PCR will be performed at an additional charge (CPT code(s): 87493).
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 toxigenicC. 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.
Alternative Names: C dif Toxin; C diff A; C diff A&B; C diff Toxin; C diff (Stool); C difficile toxin; C. diff Toxin A&B, EIA; C difficile Toxin A; C. difficile Toxin by EIA; C.diff Toxin Screen; CDT (Stool); Clos Diff A; Toxin A & Toxin B; C. difficile Toxin A, Stool; Toxin A & B, Stool
Supply: F04 - Stool Container with Red Lid
Preferred specimen(s): Unformed Stool
Preferred volume: 5grams or 5mL
Transport container: Sterile Leak-Proof Container
Transport temperature: Refrigerated
Specimen stability: Refrigerated: 5 days
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 5mL 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.
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 device 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.
CLIA