Exhaled Breath Tests (CPB 0691, reviewed 2025-10-16)
Summary
Hydrogen breath testing is covered when selection criteria are met: for evaluating suspected lactose intolerance after a 2-week trial of a lactose-free diet when symptoms persist, and for diagnosing small intestinal bacterial overgrowth (SIBO) in symptomatic patients with suspected motility disorders. Measurement of exhaled nitric oxide is covered when criteria are met for evaluating asthma and monitoring response to long-term control therapy in members aged 5 years and older. Hydrogen breath testing for all other indications, including irritable bowel syndrome, prediction of bowel preparation adequacy before colonoscopy, and small bowel transit time or gastroparesis, is considered experimental, investigational, or unproven. Exhaled nitric oxide for all other indications, including acute mountain sickness, pulmonary hypertension, chronic cough, and chronic obstructive pulmonary disease, is considered experimental, investigational, or unproven. Exhaled breath condensate pH for asthma, inflammatory bowel disease, lung cancer, obstructive sleep apnea, pulmonary diseases and SARS-CoV-2 is considered experimental, investigational, or unproven. Gastric emptying breath testing for gastroparesis and for all other indications, exhaled breath temperature, exhaled volatile organic compounds, and breath analysis for tuberculosis are also considered experimental, investigational, or unproven because their effectiveness has not been established.
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