Testing that your patients can stomach: detect active H pylori infection

H pylori  infection is one of the most common chronic bacterial infections, affecting more than a third of Americans.1 Left undetected and untreated, H pylori  can cause damage to the gastric mucosa, potentially resulting in peptic ulcers or gastric cancer.2

A prevalent bacterial infection

More than half the world’s population is infected with H pylori.3 It’s the cause of most ulcers (90%), and roughly 25 million Americans suffer from peptic ulcer disease at some point in their lifetime.4

  • 35% of Americans have H pylori 1
  • In the US, H pylori  is more prevalent among older adults, African Americans, Hispanics, and lower socioeconomic groups5
  • H pylori-related damage can lead to peptic ulcer or gastric cancer for 20–25% of patients2
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Who’s at risk for H pylori  infection?

American Gastroenterological Association (AGA) guidelines recommend H pylori  infection testing for patients with the following conditions and/or circumstances.2,3

  • Current or past gastric or duodenal ulcers
  • Uninvestigated dyspepsia
  • Gastric mucosa-associated lymphoid tissue (MALT) lymphoma
  • A family history of gastric cancer
  • First-generation immigrants from high-prevalence areas, including Africa, South America, and Western Asia
  • Initiating chronic treatment with a non-steroidal anti-inflammatory drug (NSAID)

If H pylori  infection is identified and treated, testing to monitor treatment should be performed using a urea breath test, stool antigen test, or biopsy-based testing.2 We offer resources for your patients to learn more about H pylori  testing.

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Detecting active H pylori  infection

The AGA recently updated its guidelines for H pylori  testing, moving away from serologic testing and citing a preference for the urea breath test (UBT) and stool antigen test.2

  • Though it detects the presence of antibodies in the blood, serologic testing may not detect active H pylori  infection6
  • Updated guidelines recommend that serology testing not be utilized for detection of active H pylori  infection2
  • Many health plans have designated serology testing as not medically necessary and no longer cover it, except when specific conditions apply2
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Breath vs. stool: what’s the difference?

Recommended by the AGA, both the UBT and stool antigen tests can measure active H pylori  infection. They’ve been shown to be substantially similar and can be used interchangeably.7


  • Measures urease activity
  • High sensitivity and specificity7,8
  • Can be done during a patient visit
  • May offer more convenience

Stool antigen test:

  • Identifies bacterial antigens in stool
  • High sensitivity and specificity6,7
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Rely on comprehensive H pylori testing

Quest Diagnostics offers comprehensive H pylori  infection testing for patients of all ages that’s aligned with AGA guidelines, including urea breath testing and stool antigen testing.

Test Name

Test Code

CPT Code(s)*

Helicobacter pylori  Antigen, EIA, Stool



Helicobacter pylori  Urea Breath Test



Helicobacter pylori  Urea Breath Test, Pediatric



Helicobacter pylori  Culture with Reflex to Susceptibility


87081, 87205

*The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Benefit from a better lab experience

Quest provides a better, simpler lab experience, allowing you to:

  • Send more patients to Quest—Quest Diagnostics is a UnitedHealthcare® Preferred Laboratory Network provider, which may lower patients’ out-of-pocket costs and minimize the number of labs you work with on a daily basis
  • Simplify your practice workflow—with Quanum Lab Services Manager, you can order a test with one click, check on results, order supplies, and resolve billing trailers, reducing paperwork and phone calls and letting you spend more time with patients
  • Get the insights you need—with a comprehensive menu of 3,500 tests, medical and scientific staff, and Center of Excellence, we help shape the latest thinking in advanced diagnostics, personalized care, and precision medicine
  • Enhance your patients’ engagement—with online appointment scheduling at convenient Patient Service Centers located near your practice and where your patients live, work, and shop

Prevent H pylori  progression

Learn more about our H pylori  infection testing.


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  1. Nagy P, Johansson S, Molloy‑Bland, M. Systematic review of time trends in the prevalence of Helicobacter pylori infection in China and the USA. Gut Pathog. 2016;8:8.
  2. El-Serag HB, Kao JY, Kanwal F, et al. Houston consensus conference on testing for Helicobacter pylori infection in the United States. Clin Gastroenterol and Hepatol. 2018;16(7):992-1002.
  3. Hooi JKY, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;26;[e-pub]. dx.doi.org/10.1053/j.gastro.2017.04.022.
  4. Centers for Disease Control and Prevention. Ulcers. Last updated September 15, 2017. Accessed May 29, 2019. www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/Ulcers.html.
  5. Centers for Disease Control and Prevention. Helicobacter pylori: fact sheet for providers. Last updated July 1998. Accessed May 29, 2019. www.cdc.gov/ulcer/files/hpfacts.pdf.
  6. Wang Y, Kuo F, Liu C, et al. Diagnosis of Helicobacter pylori infection: current options and developments. World J Gastroenterol. 2015;21(40):11221-11235.
  7. Dore MP, Pes GM, Bassotti G, et al. Dyspepsia: when and how to test for Helicobacter pylori infection. Gastroenterol Res Pract. 2016;2016:8463614.
  8. Kazemi S, Tavakkoli H, Habizadeh MR, et al. Diagnostic values of Helicobacter pylori diagnostic tests: stool antigen test, urea breath test, rapid urease test, serology and histology. J Res Med Sci. 2011;16(9):1097-1104.