How To Use CPT Code 81381

CPT 81381 describes the high resolution typing of HLA Class I alleles or allele groups. 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 81381?

CPT 81381 can be used to identify specific alleles for one HLA Class I allele or allele group. This test involves high resolution typing, which means looking for common well-documented alleles and typically identifying alleles to a high specificity, such as a 4-digit HLA name. It is commonly ordered to identify an HLA Class I allele or allele group that indicates a specific disease state.

2. Official Description

The official description of CPT code 81381 is: ‘HLA Class I typing, high resolution (ie, alleles or allele groups); one allele or allele group (eg, B*57:01P), each.’

3. Procedure

1. The lab analyst performs the technical lab test for high resolution assessment of HLA Class I 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 81381 is used to identify specific alleles or allele groups for HLA Class I typing. It is commonly ordered to indicate a specific disease state associated with a particular allele or allele group.

5. When to use CPT code 81381

CPT code 81381 should be used when there is a need to identify specific alleles or allele groups for HLA Class I typing. It is typically ordered to indicate a specific disease state associated with a particular allele or allele group.

6. Documentation requirements

To support a claim for CPT 81381, documentation should include the specific allele or allele group identified, the date of the test, and the interpretation of the results. The ordering clinician may also provide additional documentation related to the specific disease state being evaluated.

7. Billing guidelines

When billing for CPT 81381, ensure that the test is performed for high resolution typing of HLA Class I alleles or allele groups. It is important to follow the specific guidelines provided by the payer regarding documentation and coding requirements. Modifier 26 may be used if the ordering clinician separately requests physician interpretation of the test.

8. Historical information

CPT 81381 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 performs high resolution typing of HLA Class I alleles to identify a specific allele associated with hypersensitivity to a drug.
2. A patient undergoes HLA Class I typing to determine the presence of a specific allele associated with a particular autoimmune disease.
3. A physician orders HLA Class I typing to identify a specific allele or allele group that indicates a potential risk for graft rejection in a transplant patient.
4. A researcher uses high resolution typing of HLA Class I alleles to study the association between specific alleles and the development of certain cancers.
5. A patient undergoes HLA Class I typing to identify a specific allele or allele group that may impact their response to certain medications.
6. A lab analyst performs high resolution typing of HLA Class I alleles to identify a specific allele associated with a rare genetic disorder.
7. A physician orders HLA Class I typing to determine the presence of a specific allele or allele group that may be associated with an increased risk of developing an infectious disease.
8. A patient undergoes HLA Class I typing to identify a specific allele or allele group that may be associated with a higher likelihood of successful organ transplantation.
9. A researcher uses high resolution typing of HLA Class I alleles to investigate the genetic diversity within a specific population.
10. A lab analyst performs HLA Class I typing to identify a specific allele or allele group that may be associated with an increased risk of developing an adverse reaction to a medication.