About this policy
CMS National Coverage Determination | ncd_id=264 | manual_section=100.5 | coverage_level_code=2 | national_coverage_type=True | under_review=False | lab_ncd=False
Coverage indications
The Following Breath Test is Covered: Lactose breath hydrogen to detect lactose malabsorption. The Following Breath Tests are Excluded from Coverage: Lactulose breath hydrogen for diagnosing small bowel bacterial overgrowth and measuring small bowel transit time. CO2 for diagnosing bile acid malabsorption. CO2 for diagnosing fat malabsorption.
Documentation requirements
Item/Service Description: Diagnostic breath analyses are tests performed to measure either the hydrogen or carbon dioxide content of the breath after the ingestion of certain compounds. The analyses are performed to diagnose certain gastrointestinal disease states. Benefit Categories: 20 - Diagnostic Tests (other)
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.