Hydrogen Breath Test Kit Insurance Information

The CPT code most generally used by a physician who performs the procedural and diagnostic portion of the test is 91065 in this case, defined as "Breath Hydrogen Test"

When a breath test kit is sent to the laboratory for analysis from a physician's office, the lab bills the patient's insurance plan for the assay portion of the test only.

When the doctor is not doing the assay, the modifier -26 is attached to the code. This denotes the professional component as separate from the technical component and can be written as 91065-26.

In order to prove medical necessity for doing the hydrogen breath test, the proper diagnostic codes must be given to the laboratory by the physician.

Here are a few codes that may be applicable

271.3 Intestinal disaccharidase deficiences and disaccharide malabsorption.

271.9 Unspecified disorder of carbohydrate transport and metabolism.

558.9 Other and unspecified noninfectious gastroenterisits and colitis.

564.9 Unspecified functional disorder of intestine.

579.9 Unspecified intestinal malabsorption.