August 2007

Peter L. Morris M.D. Medical Director

BreathTek™ Urea Breath Test (UBT) is a C-urea breath test used for the detection active H. pylori infection. UBT is a patient friendly test that can confirm the presence or the eradication of H. pylori infections. The UBT tests the entire gastric mucosa and provides 95% sensitivity and 95% specificity for the detection of active H. pylori infections. With 85% sensitivity and 79% specificity, the serology test is not accurate enough for use in routine clinical practice and is no longer recommended for use in screening for H. pylori. The 2005 AGA Medical Position Statement for the Evaluation of Dyspepsia recommended that patients should receive a test and treat strategy. The article also identified that H. pylori testing is optimally performed by a C-urea breath test or a stool antigen test.

Who should you test for H. pylori?

• Patients previously infected
• Patients on PPI’s or NSAID’s
• Patients with dyspepsia
• All symptomatic family members of an H. pylori infected individual

When should you test for H. pylori?

• Before prescribing PPI’s or NSAID’s
• After treatment for H. pylori to confirm eradication. (4 weeks after completion of treatment)
• When the patient is still symptomatic

CPT Code 83013 Helicobacter pylori breath test analysis	Fee $160.00
CPT Code 83014 Drug administration and Breath Sample Collection	Fee $20.00

Laboratory ordering terminology: UBT or #123

Specimen collection is an easy non invasive procedure that is available at the Sansum Clinic Pueblo and Pesetas Laboratories as well as at the Pacific Diagnostic Laboratories Patient Service Centers. Providers simply request the test using a laboratory test requisition and give the patient a copy of the BreathTEk Patient Preparation handout which outlines the following test collection requirements.

• Prior to collection, patients are required to fast for one hour,
  • No food, liquids or smoking for at least one hour prior to specimen collection.
• Patients must abstain from the following medications for 2 weeks prior to the test.
  • All Antibiotics
  • Proton Pump Inhibitors: Prilosec®, Prevacid®, Aciphex®, Protonix®, and Nexium®
  • Bismuth Preparations: Pepto-Bismol®

Note: H2 antagonists may be substituted for PPIs. These medications do not affect test results and include Zantac®, Tagamet®, Pepsid® and Axid®.

Warnings and Precautions: Phenylketonurics, the Pranactin®–Citric powder ingested by the patient during the test contains 84 mg Phenylalanine. For reference 12 oz diet soda contains ? 80mg of phenylalanine.
Note: The BreathTekTM UBT has not been studied in patients less than 18 years of age.

Refer your questions to the Laboratory Client Service Department at (805) 692-4610.