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” |
Reimbursement Positionsmonimono2017-12-05T09:29:56+00:00