Nitric oxide expired gas determination
CPT4 code
Name of the Procedure:
Nitric Oxide Expired Gas Determination (FeNO Test, Fractional Exhaled Nitric Oxide Test)
Summary
The Nitric Oxide Expired Gas Determination, commonly known as the FeNO test, is a non-invasive procedure that measures the level of nitric oxide in the breath. This test helps in assessing inflammation in the airways, typically for patients with asthma and other respiratory conditions.
Purpose
This test is used to diagnose asthma and monitor the effectiveness of anti-inflammatory treatment. By measuring the concentration of nitric oxide in the exhaled breath, healthcare providers can gain insight into the level of inflammation in the patient’s lungs.
Indications
- Symptoms of asthma (e.g., wheezing, coughing, shortness of breath)
- Unclear diagnosis of respiratory issues
- Monitoring asthma control and response to treatment
- Adjusting medication plans for asthma management
Preparation
- Avoid eating, drinking, smoking, or exercising for at least 1 hour before the test.
- Follow specific instructions regarding existing asthma medication usage, as advised by your healthcare provider.
Procedure Description
- The patient will be asked to breathe into a handheld device similar to a tube.
- First, the patient inhales deeply to fill their lungs.
- Then, the patient exhales steadily and fully into the device, which measures the amount of nitric oxide in their breath.
- The exhalation needs to be slow and steady, often over a period of 10 seconds.
No anesthesia or sedation is required for this test.
Duration
The procedure typically takes around 10-15 minutes.
Setting
The FeNO test is usually performed in an outpatient clinic or at a healthcare provider’s office.
Personnel
- Respiratory therapist or nurse
- Primary care physician or pulmonologist
Risks and Complications
The FeNO test is generally safe and non-invasive, with minimal risk. Rarely, patients may experience:
- Mild dizziness or lightheadedness from deep breathing
- Minor discomfort during exhalation
Benefits
- Provides valuable data for diagnosing asthma
- Helps tailor and monitor asthma treatment effectively
- Quick and non-invasive with immediate results
Recovery
- No special recovery is needed.
- Normal activities can be resumed immediately after the procedure.
Alternatives
- Spirometry: Measures lung function but does not specifically indicate inflammation.
- Allergy tests: Identify allergens but do not assess airway inflammation directly.
- Bronchoscopy: More invasive, provides direct visualization and biopsy.
Patient Experience
During the procedure, the patient might feel a slight sense of exertion while exhaling deeply, but it is usually well-tolerated. There is no pain involved, and comfort measures include a calm environment and clear instructions from the healthcare provider to ensure an accurate and comfortable test experience.
Pain management is not typically necessary due to the non-invasive nature of the test.