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BREATH HYDROGEN AND METHANE ANALYSIS

Test Code
Test BREATH HYDROGEN AND METHANE ANALYSIS 
Methodology Gas Analyzer 
Description Measurement of breath hydrogen is useful for the detection of intestinal malabsorption of sugars and for the measurement of intestinal transit time when a non-absorbable sugar is ingested. An abnormal response can also result from an abnormally early response to a non-absorbable sugar, indicating an invasion of the ileum by bacteria ordinarily restricted to the colon.

NOTE: This test, when ordered on Medicare patients, is subject to the CMS Medicare Coverage Issues Manual (MCIM) Diagnostic Services policies "Breath Analysis, Diagnostic". Please verify that the diagnosis code (ICD-9) you have chosen demonstrates medical necessity for the test as documented in the physician's patient record. The CMS web site or the NorDx Limited Coverage Documentation Guide are available to assist you with this verification. A properly executed Advance Beneficiary Notice (ABN) must be submitted with the specimen if medical necessity is not demonstrated by the ICD-9 code chosen or if the frequency of a frequency-limited test is unknown. 

Specimen CALL NORDX AT (207) 662-2711 TO SCHEDULE PATIENT. TESTING IS PERFORMED AT THE MAINE MEDICAL CENTER CAMPUS BY APPOINTMENT ONLY.

NOTE: Patient should follow a diet which has avoided high fiber and slowly digested foods the day prior to testing. Patient must fast for 12 hours prior to appointment.
1. Patient should not be on antibiotics prior to testing.
2. Patient should not smoke or sleep within 2 hours prior to or during testing.
3. Patient will be given a specific sugar solution with water following the collection of the fasting specimen. 

Reference Values Negative (< 20 ppm change in hydrogen production over lowest preceding value; <12 ppm change in methane production over lowest preceding value; < 15 ppm change in the combined hydrogen and methane production over lowest preceding combined value). 
Analytic Time 1 Day 
Day(s) Test Set Up Monday through Friday 
CPT Code(s) 91065  Hydrogen breath test