# H Pylori



## stogsmom3 (Aug 14, 2018)

Can someone explain the differences between coding A04.8 and B96.81?  I want to make sure I'm coding this correctly.  The Operative note just states gastritis but it's documented that a biopsy was also done.  The Path is what came back positive for H pylori.  I'm confused on when I would use A04.8 vs b96.81.


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## thomas7331 (Aug 14, 2018)

stogsmom3 said:


> Can someone explain the differences between coding A04.8 and B96.81?  I want to make sure I'm coding this correctly.  The Operative note just states gastritis but it's documented that a biopsy was also done.  The Path is what came back positive for H pylori.  I'm confused on when I would use A04.8 vs b96.81.



The note in ICD-10 under codes B95-B97 states that _'these categories are provided for use as supplementary or additional codes to identify the infectious agent(s) in disease classified elsewhere'_, so you would not use B96.81 as a primary diagnosis, but as an additional code with the disease listed first.  In your example above, I would not code A04.8 based on a pathology result (unless you have additional documentation that this patient has an infection caused by this bacteria), because the pathology has only identified the organism, not the disease.  A clinical determination by a provider is required to make the diagnosis of an infection and to make a causal link between the organism and the disease (an organism can be a colonization or be present in a specimen without actually causing a disease).  I would use the diagnosis for gastritis since that is the indication for the procedure and for the biopsy, and would omit the B96.81 unless that has been determined to have caused the gastritis.


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