Clostridium difficile Culture with Reflex to Cytotoxin Cell Assay
Ordering Recommendation

Reference method for diagnosis of Clostridium difficile-associated diarrhea (turnaround time ≥96 hours). Preferred initial test is C. difficile toxin B gene (tcdB) by PCR (2002838).

Within 3 days
Preliminary: Negative at 2 days or as soon as positive detected
Final: Negative at 3 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Stool or Tissue 
Specimen Preparation
Stool: Transfer 5 mL stool to an unpreserved stool transport vial (ARUP supply #40910) OR place 5 mL stool in enteric transport media (Cary-Blair) (ARUP supply #29799). (Min: 1 mL) Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
Tissue: Transfer specimen immediately into anaerobe transport media (ARUP supply #16426), available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. 
Storage/Transport Temperature
Stool: Frozen. Tissue: Room Temperature. 
Unacceptable Conditions
Multiple specimens (more than one in 24 hours), formed stools, or stool in PVA or formalin. 
Unpreserved or preserved Stool: Ambient: 2 hours; Refrigerated: 48 hours; Frozen: 1 week. Tissue: Ambient: 48 hours; Refrigerated: Unacceptable; Frozen: Unacceptable. 
Reference Interval
Culture negative for Clostridium difficile.
Interpretive Data

For routine stool screening, refer to Clostridium difficile toxin B gene (tcdB) by PCR (ARUP test code 2002838).
If Clostridium difficile culture is positive, then Clostridium difficile Cytotoxin Cell Assay will be added. Additional charges apply.
Hotline History
View Hotline History
CPT Code(s)
87075; if positive add 87076; if reflexed add 87230
Component Test Code*Component Chart NameLOINC
0060140Culture, Clostridium difficile562-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please view this test within the Laboratory Test Directory found at
  • C. diff culture
  • C. difficile Culture
  • Clostridioides difficile
  • Culture, Clostridium difficile