Summary & Overview
CPT 83013: H. pylori Breath Test for Infection Detection
CPT code 83013 designates a noninvasive breath test that detects an isotope marker of Helicobacter pylori infection, an organism linked to gastritis and peptic ulcer disease. As a laboratory diagnostic procedure, this code is important nationally because it supports targeted management of patients with dyspepsia and suspected H. pylori, informs antibiotic treatment decisions, and can reduce the need for more invasive testing.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the assay, common payer coverage considerations, and typical sites of service. The publication outlines what providers and administrators need to know about CPT code 83013 without offering clinical recommendations: its clinical purpose, where the test is ordinarily performed, and typical billing patterns.
The report also summarizes available benchmarking and reimbursement context where provided, highlights relevant policy updates affecting laboratory diagnostics generally, and clarifies areas where data was not available in the input. This material is intended for national audiences including lab managers, billing staff, and policy analysts seeking a clear operational and coding-focused overview of CPT code 83013.
Billing Code Overview
CPT code 83013 describes a laboratory test in which a lab analyst evaluates multiple breath samples for the presence of an isotope that indicates infection with the bacterium Helicobacter pylori. This test is a noninvasive diagnostic assay for H. pylori, used to detect an organism that can cause irritation and ulcers of the stomach lining.
Service Type: Diagnostic laboratory service — breath test for H. pylori
Typical Site of Service: Clinical laboratory or outpatient testing facility, with samples collected in an outpatient setting and analyzed in a laboratory.
Clinical & Coding Specifications
Clinical Context
A 42-year-old adult with several months of intermittent epigastric pain, dyspepsia, and a history of nonsteroidal anti-inflammatory drug use presents to a gastroenterology clinic. After history and physical exam, the clinician suspects Helicobacter pylori infection as a cause of gastritis or peptic ulcer disease. The clinician orders a noninvasive urea breath test (UBT) coded as 83013. The patient is instructed to stop proton pump inhibitors and certain antibiotics for the recommended washout period prior to testing. On the day of the test the patient arrives at an outpatient laboratory or gastroenterology clinic; a baseline breath sample is collected, the patient ingests a labeled urea substrate, and serial breath samples are collected at prescribed intervals. The laboratory analyst measures the isotope in breath samples to detect urease activity consistent with active H. pylori infection. Results are reported to the ordering provider for treatment planning or confirmation of eradication after therapy. Typical site of service is outpatient laboratory or ambulatory clinic, with specimen processing performed in a clinical laboratory setting. Typical service type: noninvasive diagnostic breath test for infectious disease detection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the professional interpretation component is billed separately from the technical laboratory processing. |