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Test Code UBT Helicobacter pylori Breath Test

Reporting Name

H. pylori C Urea Breath Test

Useful For

Diagnostic testing for Helicobacter pylori infection in patients suspected to have active H pylori infection

 

Monitoring response to therapy

Testing Algorithm

See Helicobacter pylori Diagnostic Algorithm in Special Instructions

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Breath


Advisory Information


An alternative test for the diagnosis of active Helicobacter pylori infection in patients is the HPSA / Helicobacter pylori Antigen, Feces, which requires a different collection.



Necessary Information


For patients between 3 and 17 years old, complete the Pediatric UHR Calculation Information card: See Special Instructions for link to required form.

 



Specimen Required


Patient Preparation:

1. Patient should be fasting for 1 hour.

2. Patients should not have taken bismuth/Tritec, antibiotics, proton-pump inhibitors (eg, Prilosec, Prevacid, Aciphex, Protonix, and Nexium) or Pepto-Bismol for 2 weeks prior to testing. If these instructions are not followed, test results may be inaccurate.

3. Histamine 2-receptor antagonists (H[2]RAs) such as Pepcid, Tagamet, Axid, or Zantac should be discontinued for 24 to 48 hours before the BreathTek UBT test is administered. If these instructions are not followed, test results may be inaccurate.

4. Carafate (sucralfate) does not interfere with the test. Use of antacids does not affect the accuracy of this assay.

Supplies: H. Pylori Breath Kit (T375: fees apply)

Collection Instructions:

1. Do not collect if patient is younger than 3 years of age.

2. Follow instructions included with kit.


Specimen Minimum Volume

Bag of ’’breath’’ must be full

Specimen Stability Information

Specimen Type Temperature Time
Breath Ambient 7 days

Reference Values

Negative

Reference values apply to all ages.

Day(s) and Time(s) Performed

Monday through Friday, Sunday; 6:30 a.m.-5 p.m.

Test Classification

This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83013

LOINC Code Information

Test ID Test Order Name Order LOINC Value
UBT H. pylori C Urea Breath Test 29891-9

 

Result ID Test Result Name Result LOINC Value
81590 H. pylori C Urea Breath Test 29891-9

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

Method Name

Infrared Spectrophotometry (SP)

Forms

1. For patients between 3 and 17 years old, the Pediatric UHR Calculation Information card is required, see Special Instructions.

2. If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Microbiology Test Request (T244)

-Gastroenterology and Hepatology Client Test Request (T728)

-General Request (T239)