Pathology/Lab Coding Alert

Question: What is a CLO test, and how should I code it?

Missouri Subscriber Answer: CLO stands for "like organism." A CLO test is a direct bacterial analysis, usually by a commercial kit that performs a rapid urease test. A physician may order a CLO test in conjunction with an endoscopy and stomach biopsy to identify Helicobacter pylori infection that may be the cause of stomach ulcers.

Report a CLO test as 87077 (Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate). If your lab has a certificate of waiver under the Clinical Laboratory Improvement Amendments, append modifier -QW (CLIA waived test). The FDA has approved about six commercial kits for the presumptive identification of H. pylori in gastric biopsy tissue that you should report with this code.

You should use 87077 for the CLO test that does not involve a culture, even though the code actually describes additional biochemical methods, such as urease activity, to definitively identify a culture. When CPT 2001 removed the CLO test code (87072, Culture or direct bacterial identification method, each organism, by commercial kit, any source except urine), it directed coders to use code 87077, which was new that year.

CMS now lists all CLIA-waived CLO tests as 87077-QW. You can write "CLO test" next to 87077 in your CPT book to help you remember this coding.