H. Pylori Breath Test

Message
Performed at Sonora Quest Laboratory - test code 902147


Test Code
H PY Breath


Alias/See Also
902147


CPT Codes
83013

Instructions
Exhaled Breath Remove the cap from the mouthpiece of the blue BASELINE bag. Instruct the patient to take a deep breath, hold their breath for 4 to 5 seconds and then exhale directly into the mouthpiece of the blue BASELINE breath bag until completely full. If the bag is not full repeat the last step. Replace the cap on the bag mouthpiece and firmly press until it clicks and is securely locked into place. Prepare the test solution by dissolving the Citrica and the 13C-enriched urea tablet in 150 to 200 ml (5.1 to 6.8 oz.) of tap water in the provided drinking cup. Close the lid firmly using both hands. Place fingers over lid and shake thoroughly for a few minutes, until the Citrica Powder and the 13C-urea tablet are completely dissolved. Tiny particles may remain visible after thorough mixing. However, if more substantial particulate matter is still present after five minutes of mixing, discard the solution and repeat the procedure with a new kit. Give the prepared test drink to the patient. Ensure that the patient drinks the solution through the provided straw. The patient, including pediatric patients aged 3-17 regardless of age and bodyweight, must drink the solution within two minutes and consume the entire amount. Start the timer for 15 minutes. After the patient finishes drinking the solution, record the present time plus (+) another 15 minutes in the Time to Fill field on the gray POST INGESTION bag. Fifteen minutes after the administration of the test drink (but no later than 20 minutes after administration) remove the cap from the mouthpiece of the gray POST INGESTION bag. Instruct the patient to take a deep breath, hold their breath for 4 to 5 seconds and then exhale directly into the mouthpiece of the gray POST INGESTION bag until it is full. If the bag is not full repeat the last step. Replace the cap on the bag mouthpiece and firmly press until it clicks and is securely locked into place. Assure both filled Breath Sample Bags are correctly labeled, and all fields are complete for future identification. Place both filled Breath Sample Bags (the blue BASELINE bag and the gray POST INGESTION bag) into the provided sample transport bag. Until analyzed, Breath Sample Bags should be stored at room temperature (15-30°C, 59-86°F), protected from direct sunlight and sharp objects. Refrain from applying any external pressure on the Breath Sample Bags. Remind the patient that the Citrica contains 84mg of phenylalanine per packet of Citrica Powder. Phenylketonurics restrict dietary phenylalanine. The patient should have fasted at least one hour before administering the solution. The patient should not have taken antimicrobials, proton pump inhibitors (PPI) or bismuth preparations within two weeks prior to administering the test. Testing is appropriate for patients >= 3 years old.


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Refrigerated
Frozen


Additional Information
H. Pylori Urea Breath Test


The CPT Codes provided in this document 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 payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.