CPT® Code 78267

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.