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
  • Two patient-specific identifiers required (e.g., patient full name, date of birth, Medical record number) 
  • Identifiers on specimen must exactly match submission form.
Shipping and Specimen Handling Requirements
  • Ship according to Dangerous Goods Regulations, IATA, and/or CFR 49
  • Category B shipping applies

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.