2025 CPT code 86831
(Active) Effective Date: N/A Pathology and Laboratory Procedures - Immunology Procedures Pathology and Laboratory Feed
Antibody to human leukocyte antigens (HLA), solid phase assays (e.g., microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class II.
Modifiers may be applicable.Modifier 90 indicates the test was performed by an outside laboratory. Modifier 91 is used for repeat testing. Consult payer guidelines for appropriate modifier usage.
Medically necessary for pre- and post-transplant evaluation, assessing donor-recipient compatibility, and monitoring for potential rejection.
Performed by lab analysts to identify the presence of specific HLA Class II antibodies in patient serum using immunoassay methods.The analyst mixes the serum with antigen-coated beads, evaluates the antibody/antigen reaction using flow cytometry or ELISA, and reports the presence of antibodies to specific HLA Class II antigens.
In simple words: This test checks your blood for specific antibodies against HLA, which are proteins found on your cells.These antibodies can sometimes cause your body to reject a transplanted organ. The test helps doctors find a compatible donor for a transplant and monitor you after a transplant to make sure your body isn't rejecting the new organ.
The lab analyst performs a solid phase immunoassay using patient serum to identify the presence of specific antibodies to specific Class II human leukocyte antigens (HLA) from a panel of complete HLA Class II phenotypes.This involves mixing the serum with beads coated with HLA Class II antigens in the presence of a marker (like a fluorescent immunoglobulin) that becomes visible if an antibody/antigen reaction occurs.The reaction is evaluated using instruments and processes such as flow cytometry or ELISA, and the report identifies which antibodies in the patient's serum react to specific HLA Class II antigens.This test is often used to assess compatibility between donor and recipient for solid organ or bone marrow transplants, especially after a tissue typing test indicates compatible HLA antigens and an antibody screening shows low to moderate levels of HLA Class II antibodies. It helps identify specific antibodies in the recipient that might cause rejection despite a good tissue match. This test may be ordered periodically while a recipient awaits a transplant, as antibody status can change, or after a transplant to detect newly developed antibodies that could signal rejection.
Example 1: A patient awaiting a kidney transplant needs to be tested for HLA Class II antibodies to ensure compatibility with potential donors., A patient who recently received a bone marrow transplant needs to be monitored for the development of new HLA Class II antibodies, which could indicate transplant rejection., A patient on the waiting list for a heart transplant needs periodic HLA Class II antibody testing as antibody levels can change over time.
Documentation should include the reason for the test, relevant medical history (transplants, pregnancies, blood transfusions), and the interpretation of the test results in the context of the patient's clinical condition.
** Some payers may reimburse separately for specimen collection (e.g., 36415 for venipuncture).
- Revenue Code: T1H
- Specialties:Immunology, Transplant Medicine, Hematology
- Place of Service:Independent Laboratory, Hospital Laboratory