Gastroenterology Coding Alert

Question: Our gastroenterologist performs tests for Helicobacter pylori (H. pylori) using a C-14 breath analysis. We used to get an off-site lab to analyze the samples, but the office recently bought a liquid scintillation counter so the gastroenterologist could perform his own analyses. How should we report the H. pylori breath test and the analysis? Georgia Subscriber Answer: Offices that perform H. pylori tests and interpret the results can report two codes for the procedure. When your gastroenterologist performs the analysis and interprets the results, you should use the following codes: • 78267 (Urea breath test, C-14 [isotopic]; acquisition-for analysis) for the test • 78268 (... analysis) for the analysis. Warning: Use caution when reporting both the C-14 breath test and the analysis on the same claim. Some payers will not accept 78267 and 78268 on the same date of service. Good practice: If there is any uncertainty before filing a claim dealing with H. Pylori tests or interpretations, check with the carrier first to avoid a rejection. -- Clinical and coding expertise for this issue provided by Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the AMA's CPT Advisory Panel; and Linda Parks, MA, CPC, CMC, CMSCS, an independent coding consultant in Atlanta.