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The CPT® Code 83013 refers to a laboratory test specifically designed to analyze breath samples for urease activity, utilizing a non-radioactive isotope, such as Carbon-13 (C-13). This test is primarily employed in the diagnosis and monitoring of Helicobacter pylori (H. pylori) infections, which are associated with various gastrointestinal conditions, including chronic active gastritis, duodenal ulcers, and nonulcerative dyspepsia. H. pylori is a type of bacterium that resides in the stomach, where it burrows into the gastric mucosa to access the less acidic epithelial cells. To survive in the harsh acidic environment of the stomach, H. pylori produces an enzyme known as urease. This enzyme plays a crucial role in the bacterium's ability to thrive, as it catalyzes the conversion of urea into ammonia and carbon dioxide, leading to inflammation and an immune response in the gastric lining. The testing process begins with the collection of a baseline breath sample from the patient. Following this, the patient ingests a capsule or solution containing 75 mg of reconstituted Pranactin-Citric, which includes (13) C-urea. Once ingested, the (13) C-urea is broken down in the stomach, producing (13) CO2 and ammonia. A second breath sample is collected approximately 13 to 18 minutes after ingestion. If H. pylori is present in the stomach, the urease produced by the bacteria will facilitate the conversion of (13) C-urea into (13) CO2, which is then absorbed into the bloodstream and subsequently exhaled. The analysis of the exhaled breath is conducted using quantitative infrared spectrophotometry, a method that allows for precise measurement of the (13) CO2 levels. The CPT® Code 83013 encompasses the analysis of the breath sample and includes the costs associated with the medication and test supplies necessary for the procedure.
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The Helicobacter pylori breath test analysis (CPT® Code 83013) is indicated for the following conditions:
The procedure for the Helicobacter pylori breath test analysis involves several key steps:
After the completion of the Helicobacter pylori breath test, patients may resume their normal activities immediately. There are typically no specific post-procedure care instructions required, as the test is non-invasive and does not involve any significant recovery time. However, it is important for healthcare providers to discuss the results with the patient once they are available, as this will guide further management and treatment options if H. pylori infection is confirmed.
| Short Descr | H PYLORI (C-13) BREATH | Medium Descr | HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE | Long Descr | Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13) | 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 | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 233 - Laboratory - Chemistry and Hematology |
| 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q4 | Service for ordering/referring physician qualifies as a service exemption | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | QW | Clia waived test | U6 | Medicaid level of care 6, as defined by each state | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Short description changed. |
| 2005-01-01 | Changed | Code description changed. |
| 2002-01-01 | Changed | Code description changed. |
| 2001-01-01 | Changed | Code description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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