2025 CPT code 81381
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Molecular Pathology Procedures Pathology and Laboratory Feed
High-resolution HLA Class I typing for a single allele or allele group.
Modifier 26 may be appended if only physician interpretation is performed.Other modifiers may be appropriate depending on the circumstances (refer to NCCI guidelines and payer-specific rules).
Medical necessity is typically established by the presence of clinical symptoms, family history, or risk factors for specific conditions associated with particular HLA alleles. The ordering physician should document the clinical indication justifying this high-resolution test.
The clinical responsibility lies with the laboratory analyst who performs all technical aspects of the test, from DNA extraction to allele identification.A physician may separately interpret the results and provide a report (using modifier 26).
In simple words: This lab test identifies a specific version of a gene (HLA Class I) that helps the body fight off infections. It uses advanced techniques to pinpoint one specific version of this gene, often linked to a particular health condition or drug reaction. The test helps doctors understand why someone might have a specific disease or react badly to a medication.
This CPT code encompasses high-resolution typing of a single Human Leukocyte Antigen (HLA) Class I allele or allele group.The procedure involves the analysis of nucleic acids to identify specific alleles, typically to a 4-digit HLA name (e.g., B*57:01P).The methods employed may include amplification, hybridization with probes, or direct sequencing.The test is qualitative and includes all analytical steps from cell lysis to allele identification.Prior procedures like microdissection are reported separately.Physician interpretation may be reported separately using modifier 26.
Example 1: A patient experiences a severe reaction to carbamazepine.The physician orders 81381 to test for the HLA-B*57:01 allele, which is associated with hypersensitivity to this drug., A patient is being evaluated for a suspected autoimmune disorder. HLA Class I typing (81381) is ordered to assess specific alleles related to immune system function., Prior to organ transplantation, 81381 is used as part of the HLA tissue typing to assess compatibility between donor and recipient.
The requisition should clearly specify the HLA Class I allele or allele group being tested.The report should include the specific alleles identified, the methods used, and the level of resolution achieved.
** This code is used for high-resolution HLA Class I typing.The high resolution implies specificity to the level of a 4-digit HLA name. For rare alleles, results may be reported as a string of alleles or a National Bone Marrow Donor Program code.
- RVU: Information not available in provided text.Consult official fee schedules.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a complete procedure.
- Fee Schedule: Fee schedules vary by payer and region. Consult your specific payer's fee schedule for historical data.
- Specialties:Immunology, Rheumatology, Transplantation, Oncology, Clinical Pharmacology
- Place of Service:Laboratory