Wednesday, April 27, 2016

CPT CODE 78267, 78268, 8313, 87338 and covered ICD 10 codes

Helicobacter Pylori Testing—CPT and ICD-9/ICD-10 Covered Indications


Claims submitted with non-covered indication will be denied as provider liable.


CPT Description

78267 Urea breath test, C-14 (isotopic); acquisition for analysis
78268 Urea breath test, C-14 (isotopic); analysis
83009 Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13)
83013 Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13)
83014 Helicobacter pylori; drug administration
86677 Antibody; helicobacter pylori
87338 Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiplestep method; helicobacter pylori, stool
87339 Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiplestep method; helicobacter pylori

Related coding—Upper gastrointestinal endoscopy with biopsy codes and not otherwise classified diagnostic radiopharmaceuticals that deny when helicobacter pylori (H. pylori) testing is denied for a non covered indication:

43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple
A4641 Radiopharmaceutical, diagnostic, not otherwise classified


Code Description

B96.81 Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhere
C16.0 Malignant neoplasm of cardia
C16.1 Malignant neoplasm of fundus of stomach
C16.2 Malignant neoplasm of body of stomach
C16.3 Malignant neoplasm of pyloric antrum
C16.4 Malignant neoplasm of pylorus
C16.5 Malignant neoplasm of lesser curvature of stomach, unspecified
C16.6 Malignant neoplasm of greater curvature of stomach, unspecified
C16.8 Malignant neoplasm of overlapping sites of stomach
C16.9 Malignant neoplasm of stomach, unspecified
C82.50 Diffuse follicle center lymphoma, unspecified site
C82.59 Diffuse follicle center lymphoma, extranodal and solid organ sites
C83.80 Other non-follicular lymphoma, unspecified site
C83.81 Other non-follicular lymphoma, lymph nodes of head, face, and neck
C83.82 Other non-follicular lymphoma, intrathoracic lymph nodes
C83.83 Other non-follicular lymphoma, intra-abdominal lymph nodes
C83.84 Other non-follicular lymphoma, lymph nodes of axilla and upper limb
C83.85 Other non-follicular lymphoma, lymph nodes of inguinal region and lower
C83.86 Other non-follicular lymphoma, intrapelvic lymph nodes
C83.87 Other non-follicular lymphoma, spleen
C83.88 Other non-follicular lymphoma, lymph nodes of multiple sites
C83.89 Other non-follicular lymphoma, extranodal and solid organ sites
C84.90 Mature T/NK-cell lymphomas, unspecified, unspecified site
C84.99 Mature T/NK-cell lymphomas, unspecified, extranodal and solid organ sites
C84.A0 Cutaneous T-cell lymphoma, unspecified, unspecified site
C84.A9 Cutaneous T-cell lymphoma, unspecified, extranodal and solid organ sites
C84.Z0 Other mature T/NK-cell lymphomas, unspecified site
C84.Z9 Other mature T/NK-cell lymphomas, extranodal and solid organ sites
C85.10 Unspecified B-cell lymphoma, unspecified site
C85.19 Unspecified B-cell lymphoma, extranodal and solid organ sites
C85.20 Mediastinal (thymic) large B-cell lymphoma, unspecified site
C85.29 Mediastinal (thymic) large B-cell lymphoma, extranodal and solid organ sites
C85.80 Other specified types of non-Hodgkin lymphoma, unspecified site
C85.89 Other specified types of non-Hodgkin lymphoma, extranodal and solid organ
C85.90 Non-Hodgkin lymphoma, unspecified, unspecified site
C85.99 Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sites
C86.4 Blastic NK-cell lymphoma
C88.4 Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid
K25.0 Acute gastric ulcer with hemorrhage
K25.1 Acute gastric ulcer with perforation
K25.2 Acute gastric ulcer with both hemorrhage and perforation
K25.3 Acute gastric ulcer without hemorrhage or perforation
K25.4 Chronic or unspecified gastric ulcer with hemorrhage
K25.5 Chronic or unspecified gastric ulcer with perforation
K25.6 Chronic or unspecified gastric ulcer with both hemorrhage and perforation
K25.7 Chronic gastric ulcer without hemorrhage or perforation
K25.9 Gastric ulcer, unspecified as acute or chronic, without hemorrhage or
K26.0 Acute duodenal ulcer with hemorrhage
K26.1 Acute duodenal ulcer with perforation
K26.2 Acute duodenal ulcer with both hemorrhage and perforation
K26.3 Acute duodenal ulcer without hemorrhage or perforation
 Code Description
K26.4 Chronic or unspecified duodenal ulcer with hemorrhage
K26.5 Chronic or unspecified duodenal ulcer with perforation
K26.6 Chronic or unspecified duodenal ulcer with both hemorrhage and perforation
K26.7 Chronic duodenal ulcer without hemorrhage or perforation
K26.9 Duodenal ulcer, unspecified as acute or chronic, without hemorrhage or
K27.0 Acute peptic ulcer, site unspecified, with hemorrhage
K27.1 Acute peptic ulcer, site unspecified, with perforation
K27.2 Acute peptic ulcer, site unspecified, with both hemorrhage and perforation
K27.3 Acute peptic ulcer, site unspecified, without hemorrhage or perforation
K27.4 Chronic or unspecified peptic ulcer, site unspecified, with hemorrhage
K27.5 Chronic or unspecified peptic ulcer, site unspecified, with perforation
K27.6 Chronic or unspecified peptic ulcer, site unspecified, with both hemorrhage
K27.7 Chronic peptic ulcer, site unspecified, without hemorrhage or perforation
K27.9 Peptic ulcer, site unspecified, unspecified as acute or chronic, without
K28.0 Acute gastrojejunal ulcer with hemorrhage
K28.1 Acute gastrojejunal ulcer with perforation
K28.2 Acute gastrojejunal ulcer with both hemorrhage and perforation
K28.3 Acute gastrojejunal ulcer without hemorrhage or perforation
K28.4 Chronic or unspecified gastrojejunal ulcer with hemorrhage
K28.5 Chronic or unspecified gastrojejunal ulcer with perforation
K28.6 Chronic or unspecified gastrojejunal ulcer with both hemorrhage and
K28.7 Chronic gastrojejunal ulcer without hemorrhage or perforation
K28.9 Gastrojejunal ulcer, unspecified as acute or chronic, without hemorrhage or
K29.00 Acute gastritis without bleeding
K29.01 Acute gastritis with bleeding
K29.30 Chronic superficial gastritis without bleeding
K29.31 Chronic superficial gastritis with bleeding
K29.40 Chronic atrophic gastritis without bleeding
K29.41 Chronic atrophic gastritis with bleeding
K29.50 Unspecified chronic gastritis without bleeding
K29.51 Unspecified chronic gastritis with bleeding
K29.60 Other gastritis without bleeding
K29.61 Other gastritis with bleeding
K29.70 Gastritis, unspecified, without bleeding
K29.71 Gastritis, unspecified, with bleeding
K29.80 Duodenitis without bleeding
K29.81 Duodenitis with bleeding
K29.90 Gastroduodenitis, unspecified, without bleeding
K29.91 Gastroduodenitis, unspecified, with bleeding
K30 Functional dyspepsia
K52.89 Other specified noninfective gastroenteritis and colitis
K52.9 Noninfective gastroenteritis and colitis, unspecified
R10.11 Right upper quadrant pain
R10.12 Left upper quadrant pain
R10.13 Epigastric pain
R10.84 Generalized abdominal pain
Z87.11 Personal history of peptic ulcer disease

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