Summary & Overview
CPT 0106U: Cairn 13C–Spirulina Gastric Emptying Breath Test
CPT code 0106U designates the Cairn 13C–Spirulina Gastric Emptying Breath Test (GEBT), a proprietary, noninvasive, nonradioactive laboratory test that measures the rate of gastric emptying of solids in adults. As a PLA code, 0106U applies to a single manufacturer-specific test and signals a unique clinical offering in gastric motility assessment. Nationally, the code matters because it clarifies reporting for this specific breath test and supports claims submission and tracking for a diagnostic alternative to scintigraphic gastric emptying studies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the test, the expected service setting, and the administrative context for billing under a PLA code. The publication outlines common modifiers associated with laboratory and diagnostic services and identifies where data was unavailable in the input.
The content helps payers, providers, and policy analysts understand: the clinical context for reporting 0106U; typical sites of service where the test is performed; what a PLA designation implies for coding and claims processing; and which major payers are considered in coverage and benchmarking discussions. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 0106U is a Proprietary Laboratory Analyses (PLA) code for the Cairn 13C–Spirulina Gastric Emptying Breath Test (GEBT) from Cairn Diagnostics, d/b/a Advanced Breath Diagnostics, LLC. This test is a noninvasive, nonradioactive breath test that measures the rate of gastric emptying of solids in adult patients.
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Service type: Noninvasive diagnostic breath test measuring gastric emptying of solids
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Typical site of service: Outpatient diagnostic laboratory or clinic-based testing facility where breath testing is performed
Clinical & Coding Specifications
Clinical Context
A 45-year-old adult with several months of postprandial nausea, early satiety, bloating, and intermittent vomiting is evaluated in a gastroenterology clinic. After history, physical exam, and initial testing (basic labs and upper endoscopy) fail to identify an obstruction or alternative cause, the gastroenterologist orders a noninvasive gastric emptying assessment. The patient presents to an outpatient breath testing facility or a hospital outpatient clinic on the test day after fasting overnight. The test uses the Cairn 13C–Spirulina Gastric Emptying Breath Test (0106U) kit and protocol: the patient ingests a standardized solid meal labeled with 13C-spirulina, and serial breath samples are collected over the prescribed interval. Breath samples are analyzed by the laboratory performing the Proprietary Laboratory Analysis, and results reporting the rate of gastric emptying (e.g., T1/2 or percentage retained at time points) are returned to the ordering gastroenterologist. The ordering clinician integrates the 0106U result with clinical findings to guide management decisions such as prokinetic therapy, dietary modification, or further testing (e.g., gastric emptying scintigraphy if discordant or clinically necessary). Typical site of service is an outpatient ambulatory clinic, dedicated breath-testing laboratory, or hospital outpatient department. The service type is diagnostic gastroenterology functional testing using a proprietary breath assay.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard reporting | Use when no special circumstances apply and full global service is provided |
11 | Same as usual (default) | Rarely appended; sometimes used by payors to indicate routine service |
22 | Increased procedural services | Use when the test required significantly greater resources, time, or technical effort than usual (document justification) |
52 | Reduced services | Use when the test was partially completed or scope reduced but not discontinued |
53 | Discontinued service | Use when the test was started but aborted for patient-related or clinical reasons and report the reason in documentation |
76 | Repeat procedure by same physician (Note: not in provided list; see 78 instead) | Data not available in the input. |
78 | Unplanned return to the operating/procedure room by same physician following initial procedure for a complication | Use only if a complication from the test necessitated an immediate return for an interventional procedure (rare for this noninvasive test) |
80 | Assistant surgeon | Not typically applicable; use only if an assistant with documented role participated in a related invasive procedure |
82 | Assistant surgeon (when qualified resident not available) | Not typically applicable for this test |
AD | Medical supervision by a physician when technologist performs part of the service | Use when the technologist performs breath collections or processing under physician supervision and payors require documentation of physician supervision |
TC | Technical component | Use when billing for the laboratory's technical component (equipment, specimen processing, analysis) separately from the professional interpretation |
26 | Professional component | Use when billing only for the physician's interpretation/reporting of the 0106U test, separate from the laboratory technical component |
QX | Ordering/Referring/Prescribing Physician Modifier (Modifier) | Use when an independent practitioner other than the performing lab ordered the test and payor policies require this modifier for services requiring ordering practitioner identification |
QY | Ordering/Referring/Prescribing Physician Modifier (Lab-performed test performed under referral) | Use when the performing laboratory is billing but a qualified provider ordered the test and payor policy requires identification |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 208000000X | Gastroenterology | Ordering and interpreting clinicians for gastric emptying assessment |
| 208600000X | Internal Medicine | Primary care physicians who evaluate and refer patients for testing |
| 207Q00000X | Family Medicine | Primary care or family physicians who refer patients for evaluation of gastroparesis symptoms |
| 362M00000X | Clinical Laboratory | Laboratories performing the technical analysis and reporting the 0106U proprietary test |
| 207RC0000X | Emergency Medicine | Occasionally involved when symptoms present acutely and expedited testing is required |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
K31.89 | Other diseases of stomach and duodenum | Symptom-based gastric complaints where gastric emptying assessment can aid diagnosis |
K30 | Functional dyspepsia | Common indication for evaluating gastric emptying in patients with chronic dyspepsia and early satiety |
K21.9 | Gastro-esophageal reflux disease without esophagitis | GERD can overlap with gastroparesis symptoms; gastric emptying results may influence management in complex cases |
K59.0 | Constipation | Delayed gastric emptying is part of generalized motility disorders; testing may be considered when systemic dysmotility suspected |
G90.9 | Disorder of autonomic nervous system, unspecified | Autonomic neuropathy (e.g., diabetic) can cause gastroparesis; relevant when systemic autonomic dysfunction is suspected |
E11.40 | Type 2 diabetes mellitus with diabetic neuropathy, unspecified | Diabetes is a common cause of gastroparesis; assessment of gastric emptying helps evaluate symptoms and treatment response |
R11.0 | Nausea | Symptom code commonly used when patients present with nausea prompting gastric emptying testing |
R14.0 | Abdominal distension | Bloating and distension are common symptoms that motivate gastric emptying evaluation |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0106U | Cairn 13C–Spirulina Gastric Emptying Breath Test — proprietary breath assay measuring rate of gastric emptying of solids | Primary CPT PLA code for the specific proprietary diagnostic test; used to report the breath test result provided by Cairn Diagnostics |
91065 | Gastric emptying breath test (noninvasive) | Alternative or historically used code for noninvasive breath testing; may be used by some labs or in workflows when a non-proprietary breath test is performed |
78267 | Gastric emptying study (by scintigraphy), 3 hours, with interpretation and report | Standard nuclear medicine gastric emptying scintigraphy often ordered when breath test is not available or for confirmation; may be performed before or after 0106U if clinical discrepancy exists |
82306 | Analysis of 13C in breath (stable isotope) (Note: example analyte code) | Laboratory chemistry code for isotope analysis when reported in broader lab billing; used by some labs for technical component reporting alongside PLA codes |
99213 | Office or other outpatient visit for the evaluation and management of an established patient, low to moderate complexity | Typical E/M visit for pre-test evaluation, ordering of 0106U, and post-test management discussion |
99000 | Handling and/or conveyance of specimen for transfer from the patient to the performing laboratory (specimen handling) | Used when special specimen handling or transportation logistics apply for breath samples to the performing laboratory |