2025 CPT code 86828
Effective Date: N/A Pathology and Laboratory Procedures > Immunology Procedures Feed
Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to HLA Class I and Class II HLA antigens
Modifiers may be applicable. Modifier 59 may be used to indicate a distinct procedural service. Modifiers 90 and 91 are for reference (outside) laboratory and repeat clinical diagnostic laboratory tests, respectively.
Medical necessity is established by the clinical need to assess HLA antibody status for transplantation or investigation of transfusion reactions or other immune-related conditions. The documentation should clearly link the test to the patient's condition and treatment plan.
The lab analyst performs the technical steps to identify the presence or absence of HLA Class I and Class II antibodies in patient serum using an immunoassay method. They evaluate the antibody/antigen reaction and report a qualitative result. Clinicians order this test to evaluate compatibility for transplants and determine if a patient is sensitized to HLA Class I or Class II antigens.
In simple words: This test checks your blood for antibodies against HLA antigens. HLA antigens are proteins found on your cells, and they're important for matching you with a donor for a transplant.This test helps make sure your body won't reject a transplant.
The lab analyst performs a solid phase immunoassay using patient serum to determine the presence or absence of antibodies to human leukocyte antigen (HLA), Class I and Class II antigens.The analyst mixes the serum with beads or wells coated with Class I and II HLA antigens in the presence of a marker. The marker becomes visible if there is an antibody/antigen reaction. The analyst evaluates the reaction using an instrument and process such as flow cytometry or ELISA and reports a qualitative result. Although not limited to testing for specific conditions, this test helps identify compatibility between donor and recipient for solid organ or bone marrow transplants.
Example 1: A patient is awaiting a kidney transplant. Following tissue typing, 86828 is performed to screen the recipient's blood for antibodies against the potential donor's HLA antigens to assess the risk of rejection., A physician is evaluating a patient for a bone marrow transplant. 86828 is ordered as part of the pre-transplant workup to assess the recipient’s sensitization to HLA Class I and II antigens., A patient with a history of multiple blood transfusions experiences a reaction. 86828 is used to determine if the patient has developed HLA antibodies that might be contributing to the transfusion reaction.
Documentation should include the reason for the test, relevant medical history (transfusions, pregnancies, prior transplants), the interpretation of results, and how the results will influence the course of treatment (e.g., transplant planning).
- Revenue Code: T1H - LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE)
- Specialties:Immunology, Hematology, Pathology, Transplant Surgery
- Place of Service:Independent Laboratory, Hospital Outpatient, Outpatient Hospital, Physician Office