How To Use CPT Code 81374

CPT 81374 describes the low or intermediate resolution assessment of human leukocyte antigen (HLA) genes for one Class I antigen equivalent. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 81374?

CPT 81374 can be used to identify specific alleles for one HLA Class I antigen equivalent. This code is used for low or intermediate resolution typing, which means identifying the alleles without high specificity, such as to the level of the two-digit HLA name.

2. Official Description

The official description of CPT code 81374 is: ‘HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each.’

3. Procedure

1. The lab analyst performs the technical lab test for low or intermediate resolution assessment of HLA Class I antigen genes.
2. The lab analyst extracts nucleic acids and identifies the target HLA Class I antigen equivalent using methods such as amplification and hybridization with nucleic acid probes or direct sequencing-based typing.

4. Qualifying circumstances

CPT 81374 is commonly ordered to identify an HLA Class I antigen equivalent or allele that indicates a specific disease state. For example, B*27 is associated with an inflammatory joint condition called ankylosing spondylitis. This test can be ordered by clinicians for any patient, regardless of specific condition.

5. When to use CPT code 81374

CPT code 81374 should be used when there is a need to identify a specific HLA Class I antigen equivalent or allele. It is commonly used to determine the presence or absence of a particular allele associated with a specific disease state. This code should not be used for high-resolution typing or when testing for the presence or absence of more than two antigen equivalents at a locus.

6. Documentation requirements

To support a claim for CPT 81374, documentation should include:

• Reason for ordering the test and the specific allele of interest
• Details of the technical steps performed by the lab analyst
• Date and time of the test
• Results of the test, including the identified HLA Class I antigen equivalent or allele
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 81374, ensure that the test is performed for one HLA Class I antigen equivalent. This code should not be reported when testing for the presence or absence of more than two antigen equivalents at a locus. There are no specific guidelines for reporting CPT 81374 with other codes.

8. Historical information

CPT 81374 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing low resolution typing for HLA Class I antigen equivalent B*27 to determine the presence or absence of ankylosing spondylitis.
2. A clinician ordering CPT 81374 to identify a specific HLA Class I antigen equivalent associated with a patient’s autoimmune disease.
3. A lab analyst using CPT 81374 to determine the presence or absence of a particular allele in a patient undergoing organ transplantation.
4. A clinician ordering CPT 81374 to identify a specific HLA Class I antigen equivalent associated with a patient’s susceptibility to a certain infectious disease.
5. A lab analyst performing low resolution typing for HLA Class I antigen equivalent B*27 to assist in diagnosing a patient with a suspected autoimmune condition.
6. A clinician ordering CPT 81374 to determine the presence or absence of a specific HLA Class I antigen equivalent in a patient with a family history of a genetic disorder.
7. A lab analyst using CPT 81374 to identify a specific HLA Class I antigen equivalent associated with a patient’s risk of developing a certain type of cancer.
8. A clinician ordering CPT 81374 to determine the presence or absence of a particular allele in a patient undergoing hematopoietic stem cell transplantation.
9. A lab analyst performing low resolution typing for HLA Class I antigen equivalent B*27 to assist in diagnosing a patient with suspected inflammatory bowel disease.
10. A clinician ordering CPT 81374 to identify a specific HLA Class I antigen equivalent associated with a patient’s risk of developing a drug hypersensitivity reaction.