How To Use CPT Code 78267

CPT 78267 describes the administration of a radioactive isotope C-14 labeled solution of urea to diagnose infection of the stomach with Helicobacter pylori. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78267?

CPT 78267 can be used to describe the administration of a radioactive isotope C-14 labeled solution of urea to diagnose infection of the stomach with Helicobacter pylori. This code is used when the provider administers the solution containing urea labeled with a radioactive isotope of carbon, C-14, to the patient undergoing the test. If the patient has Helicobacter pylori infection in their stomach, the bacteria will convert urea into ammonia and carbon dioxide gas. The provider collects breath samples at specific time intervals to analyze for the presence of the bacteria.

2. Official Description

The official description of CPT code 78267 is: ‘Urea breath test, C-14 (isotopic); acquisition for analysis.’

3. Procedure

1. The provider administers a solution containing urea labeled with a radioactive isotope of carbon, C-14, to the patient undergoing the test.
2. If the patient has Helicobacter pylori infection in their stomach, the bacteria will convert urea into ammonia and carbon dioxide gas.
3. The provider collects breath samples at specific time intervals, typically six, 12, and 20 minutes after administering the solution.

4. Qualifying circumstances

Patients eligible to undergo the urea breath test with CPT 78267 are those suspected of having Helicobacter pylori infection in their stomach. The test is used to diagnose the presence of the bacteria, which is usually associated with stomach infection and may cause ulcers or stomach cancer.

5. When to use CPT code 78267

CPT code 78267 should be used when the provider administers the urea breath test with a radioactive isotope C-14 labeled solution to diagnose Helicobacter pylori infection in the stomach. It is important to note that this code only covers the acquisition of breath samples for analysis. The analysis of the breath samples should be reported separately using CPT code 78268.

6. Documentation requirements

To support a claim for CPT 78267, the provider must document the following information:

• Reason for performing the urea breath test
• Date and time of administering the solution
• Specific time intervals for collecting breath samples
• Results of the test, indicating the presence or absence of Helicobacter pylori infection
• Signature of the provider administering the test

7. Billing guidelines

When billing for CPT 78267, ensure that the provider administers the radioactive isotope C-14 labeled solution of urea to diagnose Helicobacter pylori infection. It is important to note that the analysis of the breath samples should be reported separately using CPT code 78268. There are no specific guidelines regarding reporting CPT 78267 with other codes.

8. Historical information

CPT 78267 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2005, to its current description.

9. Examples

1. A gastroenterologist administering a urea breath test with C-14 labeled solution to a patient suspected of having Helicobacter pylori infection.
2. A primary care physician performing the urea breath test on a patient with symptoms of stomach infection.
3. A gastroenterologist collecting breath samples at specific time intervals after administering the radioactive isotope C-14 labeled solution to a patient with suspected Helicobacter pylori infection.
4. A nurse assisting the provider in administering the urea breath test and collecting breath samples for analysis.
5. A nuclear medicine technologist preparing the radioactive isotope C-14 labeled solution of urea for the urea breath test.
6. A physician explaining the urea breath test procedure to a patient and obtaining their consent before administering the solution.
7. A radiologist analyzing the breath samples collected during the urea breath test using CPT code 78268.
8. A healthcare facility billing for the acquisition of breath samples for analysis during the urea breath test using CPT code 78267.
9. A medical coder ensuring accurate reporting of the urea breath test and analysis codes for reimbursement purposes.
10. A patient undergoing the urea breath test to determine the presence of Helicobacter pylori infection in their stomach.