Culture; smear for modified Gram stain (reported only if positive and culture does not grow); isolation and identification (additional charges/CPT code[s] may apply). CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed.
Anaerobic transport, aerobic/anaerobic bacterial swab transport system, CLO vial, urea agar medium
Maintain specimen at room temperature.
Causes for Rejection:
Inappropriate specimen transport device; improper labeling; specimen received after prolonged delay (usually more than 72 hours)
Establish the presence and possible etiologic role of Helicobacter pylori in cases of chronic gastric ulcer, gastritis, duodenal ulcer, dyspepsia, etc
Helicobacter pylori has been implicated as a factor associated with chronic gastritis. The clinical significance of the organism in regard to gastric or duodenal ulcers, dyspepsia, and gastric carcinoma remains unclear.1 Other factors such as pepsin, nonsteroidal anti-inflammatory agents (NSAIDs), aspirin, ischemia, stress, alcohol, and bile salts as well as H pylori all may have a role in altering the material mucosal barrier. The relative etiologic role of H pylori remains a subject of speculation. H pylori is hypothesized to secrete products capable of degrading gastric mucin. The organism may be seen in Gram stains on imprints from tissue biopsies. In one study, imprint Gram stains performed by imprint technique on biopsies from both the antrum and fundus yielded positives in 100% of 32 culture-positive cases.2
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Debongnie JC, Delmee M, Mainguet P, Beyaert C, Haot J, Legros G. Cytology: A simple, rapid, sensitive method in the diagnosis of Helicobacter pylori.Am J Gastroenterol. 1992 Jan, 87(1):20-23. PubMed 1728119
Dooley CP, Cohen H. The clinical significance of Campylobacter pylori.Ann Intern Med. 1988 Jan; 108(1):70-79. PubMed 3276266
Eastham EJ, Elliott TS, Berkeley D, Jones DM. Campylobacter pylori infection in children. J Infect. 1988 Jan; 16(1):77-79. PubMed 3367059
Marshall BJ. Should we now, routinely, be examining gastric biopsies for Campylobacter pylori? Gastric mucosal biopsy: An essential investigation in patients with dyspepsia. Am J Gastroenterol. 1988 May; 83(5):479-481. PubMed 3364408
Marshall BJ, Warren JR, Francis GJ, Langton SR, Goodwin CS, Blincow ED. Rapid urease test in the management of Campylobacter pyloridis-associated gastritis. Am J Gastroenterol. 1987 Mar; 82(3):200-210. PubMed 3548326
Taylor DN, Blaser MJ. The epidemiology of Helicobacter pylori infection. Epidemiol Rev. 1991; 13:42-59. PubMed 1765119
Veenendaal RA, Peña AS, Meijer JL, et al. Long term serological surveillance after treatment of Helicobacter pylori infection. Gut. 1991 Nov; 32(11):1291-1294.PubMed 1752457