2025 CPT code 86812
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Immunology Procedures Pathology and Laboratory Procedures Feed
HLA typing for a single antigen from HLA Class I groups A, B, or C using serological methods.
Modifiers may be applicable depending on the circumstances of service, such as location, professional component versus technical component, and more. Refer to CPT guidelines for modifier application.
Medical necessity is established when the test is ordered by a physician to determine HLA compatibility prior to organ or bone marrow transplantation.This is supported by clinical indications of the need for transplantation.Justification should include details on the transplant process and the critical role HLA matching plays in success rates.
The clinical responsibility lies with the laboratory analyst who performs the technical aspects of the HLA typing procedure using serological methods.
In simple words: This lab test checks for a specific protein (HLA) on the surface of white blood cells. It helps determine compatibility for organ or bone marrow transplants and is often the first step in ensuring a successful transplant.
This CPT code, 86812, encompasses the performance of a serological test to identify a single human leukocyte antigen (HLA) from one or more of the three major HLA Class I cell surface antigens (A, B, and C).The procedure involves the technical steps of identifying the presence of an antigen from HLA Class I groups A, B, or C using serological methods.This typically includes isolating lymphocytes from patient blood, placing them in test wells with sera containing antibodies to known HLA types, incubating with a vital dye, and evaluating cell death via phase contrast microscopy.A positive result indicates the presence of the corresponding HLA antigen.
Example 1: A patient is awaiting a kidney transplant.This test is performed to determine the compatibility of the patient's HLA type with a potential donor's HLA type, to minimize the risk of rejection., A patient is being evaluated for a bone marrow transplant.HLA typing is crucial for matching donor and recipient to increase the likelihood of transplant success., A patient is undergoing pre-surgical evaluation for a complex transplant procedure.This test is one of several conducted to assess compatibility, aiding in minimizing post-transplant complications.
* Physician order specifying the HLA antigen(s) to be tested.* Patient demographics and identifying information.* Properly collected and labeled blood sample (or other specified sample).* Detailed laboratory report including the specific HLA antigen(s) identified and any relevant interpretations.
** Always ensure accurate documentation of the specific HLA antigen tested and the methodology used (serological).
- Revenue Code: T1H (LAB TESTS - OTHER)
- RVU: Data unavailable.Refer to current CMS relative value units and conversion factors for reimbursement details.
- Global Days: Not applicable.
- Payment Status: Active
- Modifier TC rule: Technical component (TC) modifier may apply; refer to payer guidelines and local coding practices.
- Fee Schedule: Data unavailable. Consult historical fee schedules based on the effective date of the service provided.
- Specialties:Immunology, Transplant Surgery, Hematology, Oncology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Laboratory