2025 CPT code 86821
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Immunology Procedures Pathology and Laboratory Procedures Feed
Mixed lymphocyte culture (MLC) to assess HLA compatibility.
Modifiers may be applicable depending on the circumstances. For example, modifier 59 (distinct procedural service) might be added if other distinct procedures are performed on the same day, or modifier 90 (reference laboratory) may be used for tests performed by an outside lab.
Medical necessity is established when an MLC test is ordered to assess HLA compatibility prior to a planned transplant, particularly when other, more advanced HLA typing methods are unavailable or impractical.
Clinical laboratory personnel perform this test. The ordering physician interprets the results in the context of the patient's clinical presentation and transplantation plan.
In simple words: This lab test checks how well a donor's cells match a recipient's cells for a transplant. It involves growing the cells together in a lab to see if they react. A reaction means a poor match; no reaction means a good match.
This CPT code 86821 represents a mixed lymphocyte culture (MLC) test used to determine the compatibility between a transplant recipient's and a potential donor's cells based on their human leukocyte antigen (HLA) profiles.The procedure involves culturing lymphocytes from both the recipient and donor.The presence or absence of a reaction (typically measured by thymidine uptake) indicates HLA compatibility or incompatibility, respectively.This test is less frequently used now than newer, more precise HLA typing methods.
Example 1: A patient requires a kidney transplant.An MLC test is performed to assess the compatibility between the patient's lymphocytes and those of a potential kidney donor.The results guide the decision to proceed with the transplant or consider alternative donors., A bone marrow transplant is being planned.Pre-transplant MLC testing is used to evaluate the compatibility of donor and recipient hematopoietic cells.This helps minimize the risk of graft-versus-host disease (GvHD)., In a research setting, an MLC may be used to investigate immune responses in the context of other diseases or to assess the immunogenicity of novel therapies. The test is performed according to the specific protocol designed for the research study.
* Patient's demographics and medical history.* Reason for ordering the MLC test.* Donor's identity and relevant information.* Detailed results of the MLC, including any observations about cell proliferation or thymidine uptake.* Clinician's interpretation of the results and their relevance to transplantation or other clinical decision making.
** Although the MLC test was once commonly used for HLA typing, it is now less frequent due to advancements in molecular HLA typing methods.
- Revenue Code: T1H (LAB TESTS - OTHER)
- RVU: Information not available in provided source.Refer to CMS fee schedules for current RVU values.
- Global Days: Not applicable.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Information not provided; refer to CMS fee schedules for historical data.
- Specialties:Transplant surgery, immunology, hematology
- Place of Service:Laboratory