How To Use CPT Code 86805

CPT 86805 describes the lymphocytotoxicity assay, visual crossmatch with titration. 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 86805?

CPT 86805 can be used to describe the lymphocytotoxicity assay, visual crossmatch with titration. This code is used when a lab analyst performs a test by mixing donor lymphocytes with recipient serum of various increasing dilutions and microscopically observes for cell lysis that would indicate transplant incompatibility.

2. Official Description

The official description of CPT code 86805 is: ‘Lymphocytotoxicity assay, visual crossmatch; with titration.’

3. Procedure

1. The lab analyst uses a plate with multiple wells to mix donor lymphocytes and recipient serum, which may contain antibodies to specific donor lymphocyte antigens.
2. The lab analyst adds a reagent containing complement pathway proteins that will enhance any potential immune response between recipient and donor specimens, causing donor cell lysis.
3. The lab analyst evaluates the mixture under a microscope to see if the test is negative, meaning no cell lysis, or positive, indicating a donor and recipient immune response.
4. If the test is positive, the lab analyst proceeds with a titration to evaluate the intensity of the immune response by setting up serial serum dilutions and mixing each dilution with donor lymphocytes and complement proteins in wells on the test plate.
5. The lab analyst continues dilutions and microscopic evaluations until the test becomes negative.

4. Qualifying circumstances

CPT 86805 is typically ordered following tissue typing for human leukocyte antigens (HLA) to reduce the chance of transplant rejection. It is used to test for transplant incompatibility even if the donor and recipient have a good HLA type match, as the recipient may have formed antibodies to certain donor antigens. These antibodies can cause an incompatibility reaction and rejection of the donor tissue.

5. When to use CPT code 86805

CPT code 86805 should be used when performing a lymphocytotoxicity assay with titration. It is important to use this code specifically for this type of crossmatch test and not for other methods such as flow cytometry.

6. Documentation requirements

To support a claim for CPT 86805, the lab analyst must document the following information:

• Details of the test performed, including the mixing of donor lymphocytes and recipient serum, addition of complement pathway proteins, and microscopic evaluation
• Results of the test, indicating whether it was negative or positive
• If the test was positive, documentation of the titration process and the dilutions used
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86805, ensure that the test performed matches the description of the code. It is important to use this code specifically for lymphocytotoxicity assays with titration and not for other types of crossmatch tests. Additionally, be aware of any specific guidelines or requirements from payers regarding the billing of this code.

8. Historical information

CPT 86805 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs a lymphocytotoxicity assay with titration to evaluate transplant incompatibility between donor lymphocytes and recipient serum.
2. Using a plate with multiple wells, the lab analyst mixes donor lymphocytes and recipient serum, adds complement pathway proteins, and evaluates the mixture under a microscope for cell lysis.
3. If the test is positive, the lab analyst proceeds with a titration, setting up serial serum dilutions and evaluating each dilution for cell lysis.
4. The lab analyst continues the titration process until the test becomes negative, indicating no immune response between the donor and recipient specimens.
5. Based on the results of the lymphocytotoxicity assay with titration, the lab analyst provides information to clinicians to help determine the compatibility of a prospective donor and recipient tissue for transplantation.
6. A lab analyst performs a lymphocytotoxicity assay with titration to assess the immune response between donor lymphocytes and recipient serum in a potential transplant recipient.
7. Using a plate with multiple wells, the lab analyst mixes donor lymphocytes and recipient serum, adds complement pathway proteins, and observes the mixture under a microscope for any signs of cell lysis.
8. If the test is positive, the lab analyst proceeds with a titration, performing serial serum dilutions and evaluating each dilution for cell lysis.
9. The lab analyst continues the titration process until the test becomes negative, indicating no immune response between the donor and recipient specimens.
10. Based on the results of the lymphocytotoxicity assay with titration, the lab analyst provides valuable information to clinicians to guide the decision-making process for transplantation.