Codes / CPT4 / 78268

78268 Urea breath test, C-14 (isotopic); analysis

CPT4 code

CPT4

Chat with GenHealth to automate any coding or chart task.

Answer first

What does 78268 mean for coverage and prior authorization?

78268 is a CPT4 code for Urea breath test, C-14 (isotopic); analysis. Coverage and prior authorization can vary by payer, plan, diagnosis, place of service, and documentation, so teams should connect the code to the current payer policy before acting.

CPT4 reference
Review with confidence

Apply current policy criteria

Connect codes, payer policy, documentation, and cited criteria before work moves forward.

Explore policy intelligence
Handle the admin work

Automate prior authorization

Turn requirements into intake, submission, status checks, and follow-up across existing systems.

See prior auth automation
Get paid

Carry clean work into RCM

Automate billing, denials, posting, and A/R work without adding another queue for your team.

See RCM automation

This page is an operational reference, not medical or legal advice. Payer requirements change; verify current plan rules and patient-specific facts.

Name of the Procedure:

Urea Breath Test, C-14 (isotopic); Analysis

Summary

The Urea Breath Test, C-14 is a diagnostic test used to detect Helicobacter pylori (H. pylori), a bacterium that can infect the stomach lining. The test involves swallowing a capsule containing C-14 labeled urea, which, if H. pylori is present, gets broken down and releases carbon dioxide that can be measured in the breath.

Purpose

The test is primarily used to diagnose H. pylori infection, which can cause stomach ulcers and gastritis. The goal is to accurately detect the presence of H. pylori to enable appropriate treatment.

Indications

  • Persistent stomach pain
  • Indigestion
  • Chronic nausea
  • History of stomach ulcers
  • Unexplained weight loss
  • Dark stools

Preparation

  • Patients should fast for at least 6 hours before the test.
  • Avoid antibiotics and bismuth-containing medications for at least a month prior.
  • Refrain from taking proton pump inhibitors (PPIs) and H2 blockers for two weeks before the test.
  • An initial breath sample may be collected to serve as a baseline.

Procedure Description

  1. The patient swallows a capsule containing C-14 labeled urea.
  2. After a designated period (usually around 10-30 minutes), the patient exhales into a collection bag.
  3. The collected breath samples are analyzed to measure the level of radioactive carbon dioxide.

No anesthesia or sedation is required as the procedure is non-invasive.

Duration

The entire procedure typically takes about 30-60 minutes.

Setting

The procedure is usually performed in an outpatient clinic or a specialized diagnostic laboratory.

Personnel

  • A healthcare provider (such as a nurse or medical technician) to administer the test and collect samples.
  • A laboratory technician or specialist to analyze the breath samples.

Risks and Complications

  • Minimal radiation exposure from the C-14 isotope.
  • Rarely, some patients may experience mild gastrointestinal discomfort from swallowing the urea capsule.

Benefits

  • Non-invasive and relatively quick.
  • Highly accurate in detecting H. pylori infection.
  • Helps guide appropriate antibiotic therapy if H. pylori is present.

Recovery

  • Patients can resume normal activities immediately after the test.
  • No specific recovery time or restrictions are required.

Alternatives

  • Stool antigen test: Detects H. pylori proteins in the stool.
  • Blood antibody test: Identifies antibodies against H. pylori but may not distinguish active infection.
  • Endoscopic biopsy: Invasive procedure involving tissue sample collection for laboratory analysis.

Patient Experience

  • Patients might feel slight discomfort while swallowing the capsule.
  • No significant pain or discomfort is expected during the breath sample collection.
  • Patients are generally comfortable throughout the procedure and can quickly resume daily activities.

Pain management and comfort measures are typically unnecessary due to the non-invasive nature of the test.

Turn the reference into work

Automate the next step for 78268

See how GenHealth connects policy review to documentation, prior authorization, billing, and follow-up across the systems your team already uses.