How To Use CPT Code 87338

CPT 87338 describes the detection of Helicobacter pylori antigens in a patient’s stool using an immunoassay technique. 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 87338?

CPT 87338 can be used to detect the presence of specific Helicobacter pylori antigens in a patient’s stool using an immunoassay technique. This code is used when a lab analyst performs all the necessary technical steps to assess the presence of these antigens, which are specific protein particles on the surface of the bacteria. The immunoassay technique can include methods such as enzyme immunoassay (EIA), enzyme-linked immunosorbent assay (ELISA), fluorescence immunoassay (FIA), or immunochemiluminometric assay (IMCA).

2. Official Description

The official description of CPT code 87338 is: ‘Infectious agent antigen detection by immunoassay technique (eg, EIA, ELISA, FIA, IMCA), qualitative or semiquantitative; Helicobacter pylori, stool.’

3. Procedure

1. The lab analyst receives a stool specimen from the patient.
2. The analyst performs all the necessary technical steps to detect the presence of Helicobacter pylori antigens using an immunoassay technique.
3. The immunoassay technique can include methods such as EIA, ELISA, FIA, or IMCA.
4. The analyst assesses the presence or absence of specific antigens on the surface of the Helicobacter pylori bacteria.
5. The result of the test indicates whether the patient is infected with Helicobacter pylori.

4. Qualifying circumstances

CPT 87338 is used when a patient’s stool specimen is tested for the presence of Helicobacter pylori antigens using an immunoassay technique. This test is typically ordered by clinicians to determine if the patient is infected with Helicobacter pylori, which can be associated with chronic inflammation of the stomach, stomach ulcers, and stomach cancer. The test is not limited to a specific condition and can be performed on patients with suspected Helicobacter pylori infection.

5. When to use CPT code 87338

CPT code 87338 should be used when a patient’s stool specimen is tested for the presence of Helicobacter pylori antigens using an immunoassay technique. It is appropriate to use this code when the immunoassay technique, such as EIA, ELISA, FIA, or IMCA, is used to detect the specific antigens of Helicobacter pylori in the stool specimen. This code should not be used for testing culture isolates or for detecting antibodies to Helicobacter pylori.

6. Documentation requirements

To support a claim for CPT code 87338, the documentation should include:

• Indication for the test and the reason for ordering it
• Details of the immunoassay technique used, such as EIA, ELISA, FIA, or IMCA
• Date of the test and the specific stool specimen used
• Results of the test indicating the presence or absence of Helicobacter pylori antigens
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 87338, ensure that the test is performed using an immunoassay technique, such as EIA, ELISA, FIA, or IMCA, to detect Helicobacter pylori antigens in the stool specimen. This code should not be reported if the test is performed on a primary source other than stool. If the test is performed for different species or strains of the organism, or different organisms, each test should be reported separately with modifier 59. It is important to use the most specific code for the test being performed.

8. Historical information

CPT code 87338 was added to the Current Procedural Terminology system on January 1, 2000. Since then, there have been several changes to the code, including updates to the description and methodology. The most recent change occurred on January 1, 2022, when the code description was revised to include additional immunoassay techniques.

9. Examples

1. A lab analyst performs an immunoassay technique, such as EIA, to detect Helicobacter pylori antigens in a patient’s stool specimen.
2. Using an ELISA method, the lab analyst assesses the presence or absence of specific Helicobacter pylori antigens in a stool sample.
3. A patient provides a stool specimen, and the lab analyst performs an FIA immunoassay to detect the presence of Helicobacter pylori antigens.
4. Using an IMCA technique, the lab analyst tests a stool specimen for the presence of Helicobacter pylori antigens.
5. A lab analyst performs an immunoassay technique, such as EIA, to detect Helicobacter pylori antigens in a patient’s stool sample.
6. Using an ELISA method, the lab analyst assesses the presence or absence of specific Helicobacter pylori antigens in a stool specimen.