Helicobacter Pylori Serology Testing

This policy covers Helicobacter pylori serology (antibody) testing and endorses noninvasive active‑infection testing—urea breath test or validated lab stool antigen assay—for diagnosis and test‑of‑cure in patients with suspected peptic ulcer disease or other gastroduodenal disorders, low‑grade gastric MALT lymphoma, prior early gastric cancer resection, unexplained iron deficiency anemia, idiopathic thrombocytopenic purpura, those on or initiating chronic NSAIDs/low‑dose aspirin, and adults <60 with uninvestigated dyspepsia without alarm features. Serologic testing is not considered medically necessary for diagnosis or evaluating treatment effectiveness because it cannot distinguish active from past infection and is not appropriate for test‑of‑cure; urea breath or stool antigen tests are preferred and PPIs should be stopped at least two weeks before testing.

"Use urea breath test or stool antigen test for non-invasive diagnosis of H. pylori infection in patients with suspected peptic ulcer disease or other gastroduodenal disorders."