2025 CPT code 86830
(Active) Effective Date: N/A Revision Date: N/A Pathology and Laboratory Procedures - Tissue Typing Immunological Procedures Immunology Procedures Feed
Qualitative antibody identification panel for HLA Class I antigens using solid-phase immunoassays (e.g., ELISA, flow cytometry).
Modifiers may be applicable depending on the circumstances of service.Consult your payer's guidelines for appropriate modifier usage (e.g., 90 for reference laboratory).
Medical necessity for this test is established when the patient requires pre-transplant or post-transplant monitoring for HLA antibodies to prevent or detect organ or bone marrow transplant rejection.The specific criteria may vary depending on the payer.
The clinical responsibility lies with the laboratory analyst who performs the assay, analyzes the results, and reports findings to the ordering physician.
In simple words: This lab test checks a blood sample to see if there are antibodies targeting specific HLA Class I proteins. These proteins are on the surface of cells and are important for the immune system.The test helps determine compatibility for organ or bone marrow transplants.
This CPT code encompasses the performance of a qualitative solid-phase immunoassay (e.g., microspheres, beads, ELISA, flow cytometry) to identify specific antibodies against human leukocyte antigens (HLA) Class I. The assay uses a panel of complete HLA Class I phenotypes to determine the presence or absence of antibodies.The results are reported as a qualitative panel identifying the specific antibodies present in the patient serum.
Example 1: A patient is being evaluated for a kidney transplant.Pre-transplant HLA antibody testing (86830) is ordered to identify pre-existing antibodies to donor HLA Class I antigens. This helps determine transplant compatibility., A patient has received a bone marrow transplant.Periodic HLA antibody testing (86830) is performed to monitor for the development of antibodies against the donor tissue, indicating possible transplant rejection., A patient is on a waiting list for a heart transplant, and the testing is repeated several times over an extended period because the patient's antibody status is fluctuating.
* Physician's order specifying the test.* Patient demographics and medical history.* Results of prior tissue typing and antibody screening tests (if applicable).* Detailed laboratory report including the methods used and specific antibodies identified.
** This test is typically performed as part of the pre-transplant evaluation process for solid organ and bone marrow transplants. It should not be reported in conjunction with flow cytometry codes 88184-88189. If interfering antibodies are removed and the test is repeated, report the code once for each test.
- Revenue Code: T1H (LAB TESTS - OTHER)
- RVU: Information not available in provided sources.RVUs vary by payer and geographic location. Consult your specific payer's fee schedule.
- Global Days: Not applicable. This is a laboratory test, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a laboratory test, not a procedure with technical and professional components.
- Fee Schedule: Historical fee schedule information is not provided in the source data. This information is dependent on payer and location and is subject to change.
- Specialties:Transplant surgery, immunology, nephrology, oncology, hematology
- Place of Service:Office, Hospital outpatient, Hospital inpatient, Reference laboratory