CPT® Code 86805

The CPT® Code 86805 refers to a laboratory test known as the lymphocytotoxicity assay with visual crossmatch, which includes a titration process. This assay is crucial for assessing the compatibility between recipient and donor blood, particularly in the context of organ and tissue transplantation. The primary purpose of this test is to identify transplant patients who may be at risk for antibody-mediated damage to grafts, which can lead to rejection of the transplanted organ or tissue. It is particularly relevant for solid organ transplants, such as kidney, heart, and lung transplants, as well as for patients being evaluated for refractory platelet and/or bone marrow transplants who may have human leukocyte antigen (HLA) antibodies. Human leukocyte antigens are glycoproteins found on the surface of cells that play a significant role in the immune system's ability to recognize self from non-self. The presence of specific HLAs can pose a challenge to successful transplantation, as they may trigger an immune response against the transplanted material. The lymphocytotoxicity assay employs a complement-dependent method to detect immunoglobulin G (IgG) antibodies against Class I HLA (-A, -B, -C) found on nucleated cells, as well as Class II HLA (-DR, -DQ, -DP) expressed on various immune cells, including B-cells, monocytes, macrophages, dendritic cells, and activated T-cells. A positive crossmatch result indicates that the recipient has antibodies that may react against the donor's HLA, thereby increasing the risk of graft rejection. The titration aspect of the test involves systematically adding a known volume of a titrant solution to a specific quantity of the analyte solution, which helps in determining the concentration of antibodies present in the recipient's blood, further informing the transplant decision-making process.