CPT® Code 78268

The urea breath test, C-14 (isotopic), is a noninvasive laboratory procedure designed to detect the presence of the isotope 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 urease enzyme produced by H. pylori, which interacts with a radiolabeled isotope tracer, C-14. When urease acts on the tracer, it breaks down into 14CO2 and ammonia (NH4). The 14CO2 is then absorbed into the bloodstream and subsequently exhaled through the lungs. To ensure accurate results, specific preparatory steps must be followed by the patient, including the cessation of proton pump inhibitors 14 days prior to the test, avoiding H2 blockers or antacids for 24 hours before the test, and fasting for at least 6 hours. The procedure involves collecting breath samples before and after the ingestion of a C-14 capsule, with the analysis performed using a liquid scintillation counter. The physician is responsible for interpreting the results and providing a comprehensive report, which includes consideration of any factors that may affect the test outcomes.