Pathology/Lab Coding Alert

Answer: The code choice will depend on the specimen source and method your lab uses to perform the test.

Clinicians may order Helicobacter pylori testing to aid in the diagnosis of conditions such as stomach ulcer. Infection with the organism may also lead to stomach cancer.

Your lab might perform testing on one of the following specimens to indicate if the patient has an infection with H. pylori bacteria:

• Breath
• Stool
• Blood

The lab analysis may confirm the presence of H. pylori by detecting an indicator such as one of the following:

• Antigen – a substance that causes an immune response, such as a portion of an organism; or
• Antibody – a protein produced by the body in response to a specific organism; or
• Urease activity – The breakdown of urea into ammonia and carbon dioxide by the enzyme, urease.

Based on the preceding factors, you may choose one of the following codes to accurately describe your lab’s work:

• 87338 (Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; Helicobacter pylori, stool)
• 87339 (… Helicobacter pylori)
• 83013 (Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13))
• 83009 (Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13))
• 78268 (Urea breath test, C-14 (isotopic); analysis)
• 86318 (Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip))
• 86677 (Antibody; Helicobacter pylori) (This test involves a multi-step lab method, in contrast to 86318).