Discover the New Features of Our Improved Provider Manual

GHI HMO Plans Now Underwritten By HIP

State Sponsored Programs Rebranded

Changes to Medicare PPO Prior Approval Rules for PT/OT/ST

Medicaid Redesign Team Updates

Claims Corner

Behind the Scenes

Case Management Programs

EmblemHealth Pharmaceutical Management Program

Changes to Provider Attestation Form Submission

High Risk Medications for Elderly Patients

Do You Make Snap Decisions?

Does Your Office Have a Flu Immunization Champion?

Serology Testing Inappropriate for Detection of Active H. pylori Infection

Correct Billing for Mammography Services

CPT Codes for Tobacco Cessation Counseling

Healthy Beginnings PATH

Clinical Corner

News&Notes Archive


Review your information now to ensure you are correctly listed in our EmblemHealth directories. If any of your information has changed or is inaccurate, just follow our simple instructions to update your profile online. Can't update your information online? Fax your changes to our Provider Modifications team at 1-877-889-9061.

Serology Testing Inappropriate for Detection of Active H. pylori Infection

H. pylori is one of the most common infectious pathogens and is a common cause of peptic ulcers and dyspepsia with a prevalence of 30-40 percent in the US.

In an attempt to promote best practice guidelines for H. pylori testing from the American College of Gastroenterology (ACG), EmblemHealth, in conjunction with Meridian Bioscience, Incorporated and Quest Diagnostics, Incorporated launched the H. pylori initiative in 2011. A letter was sent to 2,161 providers advising against the continued use of serology testing for detecting active H. pylori infection and described alternative tests. (An endoscopy is recommended for patients over age 55 and for those under age 55 with alarming symptoms.)

Soon after, Quest Diagnostics offered on-site provider education and training to reinforce the message to providers. As a follow up, Quest Medical Directors called the top nine EmblemHealth providers with the highest utilization of serology testing to discuss practice patterns and to identify additional barriers. The providers welcomed the outreach and were able to discuss their individual practices and get a better understanding of best practices for testing H. pylori in their offices. Overall, the results for the call campaign demonstrated a 38 percent reduction of providers using the serology test.

EmblemHealth endorses the guidelines that recommend against the use of serology for H. pylori testing, and promote the use of tests for active infection, namely H. pylori stool antigen (HpSAŽ) and the 13C Urea Breath Test (UBT). The guidelines recommend test-treat-retest to confirm eradication. Both tests are available through Quest Diagnostics, our preferred laboratory provider. To order testing supplies, call your Quest representative or Quest Diagnostics Client Services at 1-866-MYQUEST or (1-866-697-8378). H. pylori guidelines and other clinical practice guidelines are available in our Clinical Corner.


  Printer Friendly Page