Pathology/Lab Coding Alert

Question: How should we code an H. pylori breath test?

Georgia Subscriber

Answer: The answer depends on which type of Helicobacter pylori (H. pylori) test the lab performs. CPT^® provides codes for a test that uses the radioisotope Carbon 14 (C-14), and a test that uses C-13.

The breath tests are a non-invasive method of detecting the presence of H. pylori, the bacteria responsible for causing gastric, peptic, and duodenal ulcers.

For analyzing the C-14 breath test, report 78268 (Urea breath test, C-14(isotopic), analysis). For the C-13 test, report 83013 (Helicobacter pylori, breath test analysis for urease activity, non- radioactive isotope (e.g., C-13)).

How it’s done: For the C-13 breath test, the healthcare provider takes a baseline breath sample from before the patient swallows a liquid C-13 sample. Approximately 30 minutes later, the provider takes another breath sample for analysis.

For the C-14 test, the patient swallows a capsule containing a low dosage of C-14. The patient then gives a breath sample by blowing into a balloon 10 minutes after ingesting the capsule. The lab then analyzes the sample using a liquid scintillation counter to determine the amount of the radioisotope in the exhaled breath.

Don’t confuse administration code: The entity that administers the carbon dose to the patient uses different codes to report that service. To report the administration of C-13 test, you should bill 83014 (Helicobacter pylori; drug administration). To report the administration of the C-14 breath test, use 78267 (Urea breath test, C-14(isotopic); acquisition for analysis).