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LABORATORY TEST DIRECTORY

Helicobacter pylori Breath Test, Pediatric

CPT Code(s): 83013
Specimen Required: Patient Preparation:This test requires the pediatric patient (3-17 years old) to fast and abstain from smoking for 1 hour prior to test administration. The patient should not have taken antibiotics, proton pump inhibitors (e.g., Prilosec, Prevacid, Aciphex, Nexium), or bismuth preparations (e.g., Pepto-Bismol) within the previous 14 days. When used to monitor treatment, the test should be performed four weeks after cessation of definitive therapy. The patient should be informed that the Pranactin-Citric drink that will be administered contains phenylalanine. Phenylketonurics restrict dietary phenylalanine.
Collect:BreathTek UBT Kit. (RDL Supply #51124) Available online through eSupply using RDL Connect or contact RDL Client Services at (888) 431-7474.
Specimen Preparation:1) Label breath collection bags with patient name, MRN, date and time of collection, and indicate Pre (blue) or Post (pink). 2) Collect the baseline (Pre) breath specimen according to the instructions in the BreathTek UBT kit. 3) After the allotted time, collect the Post breath specimen according to the instructions in the kit.Information required: Record weight, height, gender, and age.
Storage/Transport Temperature:CRITICAL ROOM TEMPERATURE. Do not freeze.
Stability:Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable
New York DOH Approval Status: This test is New York DOH approved.
Aliases:
  • 13C Urea Breath Test
  • H. Pylori Urea Breath Test
  • Helicobactor Breath Test
  • Pylori
  • Ulcer Breath Test
  • Urea Breath Test