How To Use CPT Code 78268

CPT 78268 describes the analysis of breath samples using a scintillation counter 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 78268?

CPT 78268 can be used to describe the analysis of breath samples using a scintillation counter to diagnose infection of the stomach with Helicobacter pylori. This code is used when a provider analyzes the results obtained by the testing provider who uses a liquid scintillation counter to measure the level of carbon dioxide in the breath samples and analyze them for the presence of Helicobacter pylori infection in the stomach.

2. Official Description

The official description of CPT code 78268 is: ‘Urea breath test, C-14 (isotopic); analysis.’ This code is used when the provider analyzes breath samples using a scintillation counter to diagnose infection of the stomach with Helicobacter pylori.

3. Procedure

1. The testing provider administers a radioactive isotope C-14 labeled solution of urea to the patient.
2. The patient exhales into a collection device to obtain breath samples.
3. The testing provider collects the breath samples and sends them to the provider for analysis.
4. The provider uses a scintillation counter to measure the level of carbon dioxide in the breath samples.
5. The provider analyzes the breath samples for the presence of Helicobacter pylori infection in the stomach.

4. Qualifying circumstances

CPT 78268 is used when there is a need to diagnose infection of the stomach with Helicobacter pylori. The patient must undergo a test involving the administration of a radioactive isotope C-14 labeled solution of urea. The provider analyzes breath samples using a scintillation counter to determine the presence of Helicobacter pylori infection in the stomach.

5. When to use CPT code 78268

CPT code 78268 should be used when there is a suspicion of Helicobacter pylori infection in the stomach and a urea breath test is performed to confirm the diagnosis. This code is used for the analysis of breath samples using a scintillation counter to determine the presence of the infection.

6. Documentation requirements

To support a claim for CPT 78268, the provider must document the following information:

• Patient’s symptoms or clinical indications for suspecting Helicobacter pylori infection
• Date and time of the test
• Results of the analysis, indicating the presence or absence of Helicobacter pylori infection
• Signature of the provider performing the analysis

7. Billing guidelines

When billing for CPT 78268, ensure that the analysis is performed by a qualified provider using a scintillation counter. This code should not be reported if the provider only collects the breath samples for analysis. There are no specific guidelines regarding reporting CPT 78268 with other codes.

8. Historical information

CPT 78268 was added to the Current Procedural Terminology system on January 1, 1990. The code was previously described as ‘Urea breath test, C-14; analysis’ and underwent a code change on January 1, 2005.

9. Examples

1. A patient presents with symptoms of stomach infection, and a urea breath test is performed. The provider analyzes the breath samples using a scintillation counter and confirms the presence of Helicobacter pylori infection.
2. A patient with a history of Helicobacter pylori infection undergoes a follow-up urea breath test. The provider analyzes the breath samples using a scintillation counter and determines that the infection has been successfully treated.
3. A patient with persistent symptoms of stomach infection undergoes a urea breath test. The provider analyzes the breath samples using a scintillation counter and finds no evidence of Helicobacter pylori infection.
4. A patient with a family history of stomach cancer undergoes a screening urea breath test. The provider analyzes the breath samples using a scintillation counter and detects the presence of Helicobacter pylori infection.
5. A patient with recurring ulcers undergoes a urea breath test to determine if Helicobacter pylori infection is the underlying cause. The provider analyzes the breath samples using a scintillation counter and confirms the presence of the infection.