Reimbursement Positions

Reimbursement Positions2017-12-05T09:29:56+00:00
Organization Blood Antibody Test Urea Breath Test (UBT)
Cigna1 “Serology blood testing
will not be covered to test for H. pylori...”
“The overall body of literature suggests that non-invasive testing with UBT is as clinically useful as endoscopy in managing select patients with uncomplicated upper gastrointestinal symptoms.”
Aetna2 “Blood antibody testing for H. pylori is experimental and investigational because of insufficient evidence of its effectiveness.” “Stenstrom et al (2008) stated that urea breath tests are the best way to diagnose current H. pylori infection.”
Anthem Blue Cross and Blue Shield3 “Serologic (in H. pylori testing) use is no longer recommended because it has poor predictive value, leads to increased antibiotic resistance.” “UBT (CPT codes 83013, 83014) is FDA-cleared for the initial diagnosis and to confirm eradication.”
Geisinger Health Plan4 “Eliminate the use of serology testing. Serology testing will not be reimbursed.” “UBT (CPT codes 83013, 83014) is FDA-cleared for the initial diagnosis and to confirm eradication.”
United Healthcare5 “Helicobacter pylori (H. pylori) serology testing is unproven and not medically necessary for diagnosing infection or evaluating treatment effectiveness” “The urea breath test and stool antigen test identify active infection where the antibody test indicates only the presence of H. pylori at some time”