2025 ICD-10-CM code B96.81
(Active) Effective Date: N/A Infectious and parasitic diseases - Bacterial and viral infectious agents Certain infectious and parasitic diseases Feed
Helicobacter pylori (H. pylori) as the cause of diseases classified elsewhere.
Medical necessity for B96.81 is established when the H. pylori infection is documented as the cause or a contributing factor to the other diagnosed condition. The infection must be confirmed through appropriate diagnostic testing, and the link between the infection and the other condition must be clinically documented.
The bacterium H. pylori causes stomach infections, usually during childhood. It is the most common cause of peptic ulcer, causing severe stomach pain. Symptoms, diagnostic studies and procedures, and treatment depend on the disease. Bacteria are generally treated with antibiotics.
In simple words: This code identifies H. pylori bacteria as the cause of an illness found in another part of the body. H. pylori is a common bacteria that can cause infections and ulcers in the stomach. Your doctor will use this code along with another code that describes the specific illness caused by H. pylori.
This code identifies H. pylori bacteria as the cause of a disease classified elsewhere. Use this code in conjunction with other code(s) identifying the disease(s) or condition(s). This code should not be used as the first-listed or principal diagnosis but should follow the disease or condition code(s).
Example 1: A patient presents with duodenal ulcer (K26.0). During an endoscopy, H. pylori is identified. Both K26.0 and B96.81 are coded with K26.0 listed first., A patient with chronic gastritis (K29.5) is tested positive for H. pylori. Both K29.5 and B96.81 should be reported, with K29.5 sequenced first., A patient presents with gastric MALT lymphoma (C88.82). A biopsy reveals H. pylori infection. The codes C88.82 and B96.81 are reported, with C88.82 as the principal diagnosis.
Documentation of H. pylori infection confirmed through diagnostic testing (e.g., biopsy, urea breath test, stool antigen test) is crucial. Documentation should also clearly link the H. pylori infection causally to the other diagnosed condition.
- Specialties:Gastroenterology, Internal Medicine, Family Medicine, Infectious Disease
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office, Independent Clinic