ICD Code B96.81

ICD code B96.81 is used to identify Helicobacter pylori [H. pylori] as the causative agent of diseases that are classified under different primary conditions. This code is typically used as a secondary diagnosis to indicate that H. pylori is the underlying bacterial cause contributing to the primary disease, such as peptic ulcers or gastritis.

1. Gastrointestinal Symptoms: Presence of persistent abdominal pain, bloating, or discomfort, particularly in the upper abdomen, which may suggest peptic ulcer disease or gastritis.

2. Dyspepsia: Chronic indigestion or a burning sensation in the stomach, often accompanied by nausea or vomiting.

3. Unexplained Weight Loss: Significant and unintentional weight loss that cannot be attributed to other medical conditions.

4. Recurrent Gastric Ulcers: History of recurring gastric or duodenal ulcers that do not respond well to standard treatment.

5. Positive Urea Breath Test: A confirmed positive result from a urea breath test, which is a non-invasive method to detect H. pylori infection.

6. Positive Stool Antigen Test: Detection of H. pylori antigens in the stool, indicating an active infection.

7. Endoscopic Findings: Evidence of gastritis, ulcers, or other gastric abnormalities observed during an endoscopy, with biopsy samples testing positive for H. pylori.

8. Family History: A family history of gastric cancer or peptic ulcer disease, which may increase the suspicion of H. pylori involvement.

9. Persistent Symptoms Post-Treatment: Continued gastrointestinal symptoms after initial treatment for peptic ulcer disease, suggesting possible H. pylori infection.

10. Anemia: Unexplained iron deficiency anemia, which may be associated with chronic gastrointestinal bleeding due to H. pylori-related ulcers.

These criteria help healthcare providers determine when it is appropriate to use the ICD code for H. pylori as the cause of diseases classified elsewhere, ensuring accurate diagnosis and effective treatment planning.

For the ICD code B96.81, which identifies Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhere, the relevant CPT codes that may be applicable for treatment or diagnostic procedures include:

1. CPT 78267 - Urea breath test for Helicobacter pylori, C-14 (isotopic).

2. CPT 78268 - Urea breath test for Helicobacter pylori, C-13 (non-radioactive isotopic).

3. CPT 83013 - Helicobacter pylori breath test analysis for urease activity.

4. CPT 83014 - Helicobacter pylori breath test specimen collection.

5. CPT 43239 - Upper gastrointestinal endoscopy with biopsy, which may be used to diagnose or assess conditions related to H. pylori.

6. CPT 88305 - Surgical pathology, gross and microscopic examination, which may be used for biopsy specimens obtained during endoscopy.

These CPT codes are typically used in conjunction with the ICD code B96.81 to ensure accurate billing and documentation for procedures related to the diagnosis and management of conditions caused by H. pylori. Always consult the latest coding guidelines and payer policies to ensure compliance and accuracy in coding practices.

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