CPT® Code 86830

Official Description

Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class I

Common Language Description

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, such as microorganisms and non-self cells. The HLA system is divided into two main classes: Class I and Class II. The testing associated with CPT® Code 86830 focuses specifically on HLA Class I. This procedure is essential for identifying the presence and characteristics of HLA alloantibodies, which are antibodies that the immune system produces against foreign HLA antigens. Such testing is particularly important in the context of organ transplantation, as it helps predict the risk of an immunological response to transplanted organs. The procedure utilizes complete HLA phenotypes to identify a wide range of antibodies, with the capability of detecting as many as 80 different antibodies through the use of a bead array containing 50 or more beads. The testing methods often employed include enzyme-linked immunosorbent assay (ELISA) and flow cytometry, which can be enhanced with Luminex technology to improve detection accuracy and efficiency.

1. Indications

The procedure associated with CPT® Code 86830 is indicated for the following conditions:

Organ Transplantation Testing is performed to assess the risk of immunological response to organ transplants by identifying HLA alloantibodies.
Transfusion Reactions It may be utilized in cases of suspected transfusion reactions to determine the presence of HLA antibodies that could lead to complications.
Autoimmune Disorders The test can assist in the evaluation of certain autoimmune disorders where HLA antibodies may play a role in disease pathology.

2. Procedure

The procedure for CPT® Code 86830 involves several key steps to ensure accurate identification of HLA antibodies:

Sample Collection A blood sample is collected from the patient, which will be used for the testing of HLA antibodies.
Preparation of Bead Array A bead array is prepared, which contains microspheres or beads coated with specific HLA antigens. This array is designed to capture any HLA antibodies present in the patient's serum.
Incubation The patient's serum is incubated with the bead array, allowing any HLA antibodies to bind to the antigens on the beads.
Detection After incubation, a detection reagent is added, which may include fluorescently labeled secondary antibodies that bind to the HLA antibodies. This step is crucial for visualizing the presence of antibodies.
Analysis The beads are then analyzed using flow cytometry or Luminex instrumentation, which quantifies the binding events and identifies the specific HLA antibodies present based on the fluorescence intensity.

3. Post-Procedure

After the procedure, the results are interpreted by a qualified healthcare professional. The identification of HLA antibodies can provide critical information regarding the patient's immunological status and potential risks associated with organ transplantation or transfusion. Patients may be monitored for any adverse reactions, and further testing may be recommended based on the findings. It is essential to document the results accurately and communicate them to the relevant healthcare providers involved in the patient's care.

Short Descr	HLA CLASS I PHENOTYPE QUAL
Medium Descr	ANTIBODY HLA CLASS I PHENOTYPE PANEL QUALITATIVE
Long Descr	Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); antibody identification by qualitative panel using complete HLA phenotypes, HLA Class I
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	2
CCS Clinical Classification	235 - Other Laboratory

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.