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The human leukocyte antigen (HLA) system is a critical component of the major histocompatibility complex (MHC), which plays a vital role in the immune system by facilitating self-recognition. This means that the MHC helps the body identify its own cells and tissues, distinguishing them from foreign substances, including pathogens and non-self cells. The HLA system is divided into two main classes: Class I and Class II. The CPT® Code 86828 refers to a specific laboratory test that qualitatively assesses the presence or absence of antibodies against HLA Class I and Class II antigens. This test is essential for evaluating the risk of an immunological response in patients undergoing organ transplantation. The assessment is typically conducted using solid phase assays, such as enzyme-linked immunosorbent assay (ELISA), which utilizes fluorescent beads coated with HLA molecules. These beads can be analyzed through conventional flow cytometry or advanced Luminex technology, allowing for precise detection of HLA alloantibodies. The results of this test are crucial for determining compatibility between organ donors and recipients, thereby aiding in the prevention of transplant rejection.
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The test associated with CPT® Code 86828 is indicated for the following:
The procedure for conducting the test associated with CPT® Code 86828 involves several key steps:
After the completion of the test associated with CPT® Code 86828, the laboratory will analyze the results and provide a report detailing the presence or absence of antibodies to HLA Class I and Class II antigens. The results are typically reviewed by a healthcare provider, who will interpret the findings in the context of the patient's clinical situation. If antibodies are detected, further evaluation may be necessary to assess the implications for organ transplantation. Patients may not require any specific post-procedure care, but they should follow up with their healthcare provider to discuss the results and any potential next steps in their treatment or transplant evaluation process.
| Short Descr | HLA CLASS I&II ANTIBODY QUAL | Medium Descr | ANTIBODY HLA CLASS I & CLASS II ANTIGENS QUAL | Long Descr | 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 | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 235 - Other Laboratory |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Added | Added |
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