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Acid Fast Bacilli (AFB) Smear

Laboratory Fee Schedule

Procedure: MAH0068A

CPT: 87206

Synonym(s):	Smear, Concentrated (AFB) smear
Requisition Form	G-MYCO
Test Description	Microscopic Examination of Clinical Specimen for Acid-Fast Bacilli (AFB)
Pre-Approval Needed	N/A
Supplemental Information Required	N/A
Supplemental Form(s)	N/A
Performed on Specimens from (sources)	Clinical specimen
Sample/Specimen Type for Testing	Sputum Tissue Exudate Stool Body Fluids
Minimum Volume/Size Required	3 mL to 15 mL
Storage/Preservation Prior to Shipping	Transport specimen as soon as possible. If transport is delayed over one hour, refrigerate specimen.
Transport Medium	Do not use transport medium. A sterile, leak-proof, 50 mL conical tube preferred for primary container. Add up to 10 mL sterile saline to tissue, if needed to maintain moisture during transport.
Specimen Labeling	At least two patient identifiers are 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 Biological Substance, UN3373 shipping requirements apply. Handle as infectious agent using universal precautions. Triple-contain in accordance with federal shipping regulations. Submitters are responsible for packaging and shipping specimens according to regulatory requirements. Ship on frozen cold packs if at all possible!
Method	Truant’s Acid Fast Stain
Turn-around Time	24 hours
Interferences/Limitations	A negative microscopic examination does not mean that the patient’s specimen cannot be culture positive for AFB. This test is less sensitive than culture. The stain utilizes a fluorescent dye that can be taken up by the mycobacterium to different degrees depending on the species or if the patient is on antibiotic treatment. The quality of the specimen has major impact on the results of the microscopic examination.
Common Causes for Rejection	Specimen leaked in transit. Missing identifier(s) on specimen container. No test requested on G-MYCO requisition form. Specimens received frozen, in formalin, or in culture medium will be rejected. Swabs are discouraged unless the only specimen available; submit swabs in 5 to 10 mL sterile saline. Gastric specimens must be neutralized prior to transport.
Additional Information	Report Interpretation: The report states whether the test is negative if no AFB are seen or positive if AFB are seen on microscopic examination. If positive, the report provides a quantitation to indicate how many AFB were seen in a high power field under the microscope.