CPT® Code 91065

Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)

The breath hydrogen or methane test, identified by CPT® Code 91065, is a diagnostic procedure utilized to assess various gastrointestinal tract disorders. This test is particularly effective in evaluating conditions such as lactose intolerance, which is characterized by a deficiency in the enzyme lactase, and fructose intolerance, where the body is unable to properly absorb fructose. Additionally, the test is instrumental in detecting bacterial overgrowth in the small intestine, a condition where bacteria that typically reside in the colon proliferate in the small bowel, leading to excessive gas production. Furthermore, the breath test can help identify motility disorders, including rapid or prolonged oro-cecal gastrointestinal transit, which can affect the digestion and absorption of sugars. In a healthy individual, sugars like lactose, fructose, and glucose are absorbed in the small intestine. However, in cases of lactase deficiency or other malabsorption conditions, these sugars are not fully absorbed and instead pass into the large intestine. There, they undergo fermentation, resulting in the production of hydrogen and methane gases. The presence of these gases can also indicate bacterial overgrowth, which may occur when the normal balance of gut bacteria is disrupted, allowing gas-producing bacteria to thrive in the small intestine. The breath hydrogen or methane test is performed by having the patient fast for at least 12 hours prior to the procedure. A baseline breath sample is collected to measure the initial levels of hydrogen and methane. Following this, the patient ingests a small amount of a test sugar, after which additional breath samples are taken at 15-minute intervals over a period of 3 to 5 hours. The analysis of these samples helps determine whether there is malabsorption of the test sugar, as indicated by elevated levels of hydrogen or methane in the breath after ingestion.