AFB – Mycobacterium kansii, Rifampin Susceptibility by Agar Proportion

Laboratory Fee Schedule
Procedure #:  MBZ0266A
CPT:  87190

Mycobacteria, M. kans, Rifampin, Susceptibility testing
Requisition Form G-MYCO
Test Description Susceptibility to rifampin by agar proportion for M. kansasii
Pre-Approval Needed N/A
Supplemental Information Required N/A
Supplemental Form(s) N/A
Performed on Specimens from (sources) Pure isolate from human sources.
Pre-Approval Needed M. kansasii pure isolate in liquid or on solid culture medium.
Minimum Volume/Size Required
  • Liquid culture - 2.0 mL
  • Solid culture - Visible growth, more than a single colony.
Storage/Preservation Prior to Shipping Ambient
Transport Medium N/A
Specimen Labeling
  • At least two patient identifiers required on specimen (e.g., patient full name, date of birth, medical record number). 
    •    Three patient identifiers are preferred. 
    •    Patient identifiers on specimen label must exactly match identifiers on submission form. (e.g., abbreviated name on label and full name on form is not acceptable.)
    •    Additional DSHS Laboratory specimen labeling guidelines available online here
Shipping and Specimen Handling Requirements
  • Ship according to Dangerous Goods Regulations, IATA, and/or CFR 49.
  • Category B shipping applies
Method Agar proportion susceptibility test interpreted as either susceptible or resistant to a specific drug at critical concentration recommended by CLSI.
Turn-around Time 14 days
Common Causes for Rejection
  • Mixed cultures
  • Isolate other than M. kansasii
  • Insufficient sample (non-viable/no grow
  • Missing identifiers on specimen or submission form
  • Mismatch between specimen and/or submission form identifiers
Additional Information
  • Isolates submitted for this test will be identified by this laboratory.  
  • No fee will be charged for this identification unless identification is requested on the G-MYCO requisition form.