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Test Code X BREATH HYDROGEN AND METHANE ANALYSIS

Important Note

 

Please call NorDx Customer Solutions at 800-396-5814 or 207-396-7830 to schedule testing.

 

Please click HERE for patient preparation instructions.

 

Challenge Sugar  NorDx Test Code Collection Detail
Lactose Intolerance LACTO 3 hour collection post-lactose
Lactose Intolerance (Modified) LACM Breath H2 and CH4, 4-hour collection post lactose
Fructose Intolerance FRU Breath H2 and CH4, 3-hour collection post fructose
Sucrose Intolerance SUC Breath H2 and CH4, 3-hour collection post sucrose
Small Intestinal Bacterial Overgrowth (SIBO): Glucose BOGLU Breath H2 and CH4, 3-hour collection post glucose
Small Intestinal Bacterial Overgrowth (SIBO): Lactulose BOLTU Breath H2 and CH4, 3-hour collection post lactulose

Performing Laboratory

NorDx Laboratories

Useful For

Measurement of breath hydrogen and breath methane is useful for the detection of intestinal malabsorption of sugars and for the measurement of intestinal transit time when a non-absorbable sugar is ingested. An abnormal response can also result from an abnormally early response to a non-absorbable sugar, indicating an invasion of the ileum by bacteria ordinarily restricted to the colon.

Reference Values

Interpretation Help for Hydrogen/Methane Breath Tests:

 

These are only guidelines, other determining factors known by the physician should be considered.

 

Lactose, Fructose or Sucrose Intolerance:

Suspected Positive:

-Hydrogen Production Only: 20 ppm delta increase in Hydrogen from the lowest preceding value in the test.

-Methane (CH4) Production Only: 12 ppm delta increase in Methane from the lowest preceding value in the test.

-Hydrogen/Methane Both Produced: Add both H2 and CH4 values together in each sample. Then review for a 15 ppm delta increase from the lowest preceding value.

 

Small Intestinal Bacterial Overgrowth (SIBO):

Suspected Positive:

Option 1: Glucose (Dextrose)

-Hydrogen Production Only: 12 ppm delta increase in Hydrogen from the lowest preceding value in the test.

-Methane (CH4) Production Only: 12 ppm delta increase in Methane from the lowest preceding value in the test.

-Hydrogen/Methane Both Produced: Add both H2 and CH4 values together in each sample. Then review for a 12 ppm delta increase from the lowest preceding value.

Option 2: Lactulose

-Early increase within the first 2 hours (small intestine) followed by a second increase (colonic response).

-Some patients do not present a double peak, but plateau instead. This may be due to SIBO being distal.

-Hydrogen Production Only: 20 ppm delta increase in Hydrogen from the lowest preceding value in the test

-Methane (CH4) Production Only: 12 ppm delta increase in Methane from the lowest preceding value in the test.

-Hydrogen/Methane Both Produced: Add both H2 and CH4 values together in each sample. Then review for a 15 ppm delta increase from the lowest preceding value.

Days and Times Test Performed

Monday through Friday

Report Available

1 Day

Specimen Type

Breath Collection Container

Specimen Collection and Handling

Please call NorDx Customer Solutions at 800-396-5814 or 207-396-7830 to schedule testing. 

TESTING IS PERFORMED AT THE MAINE MEDICAL CENTER CAMPUS BY APPOINTMENT ONLY.

NOTE: Patient should follow a diet which has avoided high fiber and slowly digested foods the day prior to testing. Patient must fast for 12 hours prior to appointment.

  1. Patient should not be on antibiotics prior to testing.
  2. Patient should not smoke or sleep within 2 hours prior to or during testing.
  3. Patient will be given a specific sugar solution with water following the collection of the fasting specimen.

Specimen Stability Information

Specimen Type: Breath Collection Container

Room Temp: 2 Weeks

Add On Capable

Not Permitted

Advance Beneficiary Notice Requirements

This test, when ordered on Medicare patients, is subject to the National Coverage Determination (NCD) policies. Please verify that the diagnosis code (ICD code) you have chosen demonstrates medical necessity for the test as documented in the physician’s patient record. The CMS web site is available to assist you with this verification. A properly executed Advance Beneficiary Notice (ABN) must be submitted with the specimen if medical necessity is not demonstrated by the ICD code chosen.

CPT Code Information

CPT Code

CPT Description

CPT Disclaimer
91065 Hydrogen breath test  

Keywords

FRUCTOSE INTOLERANCE

LACTOSE INTOLERANCE

SUCROSE INTOLERANCE

SMALL INTESTINAL BACTERIAL OVERGROWTH (SIBO)

Performing Laboratory Location

NorDx Laboratories