© Copyright 2025 American Medical Association. All rights reserved.
The urea breath test, identified by CPT® Code 78267, is a noninvasive laboratory procedure designed to detect the presence of carbon dioxide (14CO2) in exhaled breath. This test is particularly useful in diagnosing infections caused by the gram-negative bacterium Helicobacter pylori (H. pylori), which is known to be a contributing factor in chronic gastritis, as well as duodenal and peptic ulcers. Furthermore, H. pylori infection has been linked to more serious conditions such as gastric adenocarcinoma and gastric lymphoma. The mechanism of the test relies on the bacterium's production of urease, an enzyme that interacts with a radiolabeled isotope tracer, C-14. When urease is present, it catalyzes the conversion of the tracer into 14CO2 and ammonia (NH4). The resulting CO2 is then absorbed into the bloodstream and subsequently exhaled through the lungs. To ensure accurate results, specific preparatory steps must be followed prior to the test. Patients are advised to discontinue proton pump inhibitors at least 14 days before the test, while H2 blockers and antacids should not be taken for 24 hours prior. Additionally, a fasting period of at least 6 hours is required. The procedure begins with the collection of a control breath sample, where the patient holds their breath for 5 to 10 seconds before exhaling into a collection device, such as a balloon or scintillation vial. Following this, the patient ingests a capsule containing the C-14 isotope with water. After a waiting period of 10 to 15 minutes, another breath sample is collected in the same manner. The samples are then analyzed using a liquid scintillation counter, and the physician reviews the data to identify any factors that may affect the test results, such as previous gastric surgeries or recent antibiotic use. The final interpretation of the test is conducted by the physician, who provides a comprehensive written report detailing the findings.
© Copyright 2025 Coding Ahead. All rights reserved.
The urea breath test (CPT® Code 78267) is indicated for the following conditions:
The urea breath test procedure involves several key steps to ensure accurate measurement of exhaled 14CO2. The process begins with the patient preparing for the test by fasting for a minimum of 6 hours and avoiding certain medications, such as proton pump inhibitors for 14 days prior, and H2 blockers or antacids for 24 hours before the test. Initially, a control breath sample is collected. The patient is instructed to hold their breath for 5 to 10 seconds and then exhale into a collection device, which may be a balloon or scintillation vial. This control sample serves as a baseline for comparison. Following the control sample, the patient swallows a capsule containing the C-14 isotope with water. After a waiting period of 10 to 15 minutes, the patient repeats the breath-holding and exhalation process to collect a second breath sample. This second sample is crucial as it will be analyzed for the presence of 14CO2, which indicates the activity of H. pylori in the stomach. The collected samples are then measured using a liquid scintillation counter, which quantifies the amount of 14CO2 present. The physician subsequently reviews the patient data, taking into account any factors that could potentially interfere with the test results, such as prior gastric surgeries or recent antibiotic therapy. The final interpretation of the test results is conducted by the physician, who prepares a written report detailing the findings.
After the completion of the urea breath test, patients may resume their normal activities immediately, as the procedure is noninvasive and does not require any recovery time. However, it is essential for the physician to review the results carefully, as various factors can influence the accuracy of the test. The physician will provide a written report that includes the interpretation of the test results, which may indicate the presence or absence of H. pylori infection. If the test is positive, appropriate treatment options will be discussed with the patient. In cases where the test results are inconclusive or negative, further evaluation may be necessary to determine the underlying cause of the patient's symptoms.
| Short Descr | BREATH TST ATTAIN/ANAL C-14 | Medium Descr | UREA BREATH TEST C-14 ISOTOPIC ACQUISJ ANALYSIS | Long Descr | Urea breath test, C-14 (isotopic); acquisition for analysis | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | I1E - Standard imaging - nuclear medicine | MUE | 1 | CCS Clinical Classification | 209 - Radioisotope scan and function studies |
| MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | MH | Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider |
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| 2005-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |