How To Use CPT Code 86825

CPT 86825 describes the procedure for performing a non-cytotoxic crossmatch test using flow cytometry to evaluate human leukocyte antigen (HLA) compatibility. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 86825?

CPT 86825 is used to describe the procedure for performing a non-cytotoxic crossmatch test using flow cytometry. This test evaluates the compatibility of human leukocyte antigens (HLA) between donor lymphocytes and an initial recipient serum sample or dilution. It helps determine if the recipient serum contains HLA antibodies that could react against potential donor HLA antigens.

2. Official Description

The official description of CPT code 86825 is: ‘Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution.’

3. Procedure

1. The lab analyst incubates donor lymphocytes, which express HLAs, with recipient serum to allow an antibody-antigen reaction.
2. The lab analyst adds specific antibodies with dye color labels to stain specific HLA antibody-antigen conjugates that may form during the incubation.
3. The lab analyst uses a flow cytometer to evaluate the stain intensity of the different dyes in the patient serum compared to control serum.
4. The lab analyst produces a crossmatch score, which provides information about specific HLA antibodies present in the recipient serum that could react against potential donor HLA antigens.

4. Qualifying circumstances

CPT 86825 is typically ordered following tissue typing for HLA to determine the compatibility of a prospective donor and recipient tissue before performing a transplant. It is used to identify if the recipient has formed antibodies to certain donor antigens, called donor-specific antibodies, which could cause an incompatibility reaction and donor tissue rejection. The test is performed using flow cytometry and does not involve cytotoxicity crossmatch methods.

5. When to use CPT code 86825

CPT code 86825 should be used when performing a non-cytotoxic crossmatch test using flow cytometry to evaluate HLA compatibility between donor lymphocytes and an initial recipient serum sample or dilution. It is typically ordered as a follow-up test in a series of lab evaluations to reduce the chance of transplant rejection.

6. Documentation requirements

To support a claim for CPT 86825, the documentation should include:

• Details of the recipient’s tissue typing and HLA compatibility
• Description of the procedure performed, including the use of flow cytometry
• Date and time of the test
• Results of the crossmatch score and any specific HLA antibodies identified
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86825, ensure that the procedure involves a non-cytotoxic crossmatch using flow cytometry. Do not report additional flow cytometry method codes in addition to CPT 86825. It is important to follow specific payer guidelines for reporting and billing this code.

8. Historical information

CPT 86825 was added to the Current Procedural Terminology system on January 1, 2010. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs a non-cytotoxic crossmatch test using flow cytometry to evaluate HLA compatibility between donor lymphocytes and an initial recipient serum sample.
2. Following tissue typing for HLA, a clinician orders a non-cytotoxic crossmatch test using flow cytometry to determine if the recipient has formed donor-specific antibodies.
3. A patient who previously received a blood transfusion undergoes a non-cytotoxic crossmatch test using flow cytometry to assess HLA compatibility for a potential organ transplant.
4. A lab analyst uses flow cytometry to evaluate the stain intensity of different dyes in a patient’s serum compared to control serum, producing a crossmatch score.
5. After tissue typing, a clinician orders a non-cytotoxic crossmatch test using flow cytometry to ensure HLA compatibility between a donor and recipient for a bone marrow transplant.
6. A lab analyst performs a non-cytotoxic crossmatch test using flow cytometry to identify specific HLA antibodies present in a recipient’s serum that could react against potential donor HLA antigens.
7. Following tissue typing, a clinician orders a non-cytotoxic crossmatch test using flow cytometry to assess HLA compatibility between a donor and recipient for a kidney transplant.
8. A lab analyst adds specific antibodies with dye color labels to stain specific HLA antibody-antigen conjugates during a non-cytotoxic crossmatch test using flow cytometry.
9. Using flow cytometry, a lab analyst evaluates the stain intensity of different dyes in a patient’s serum compared to control serum to determine HLA compatibility in a non-cytotoxic crossmatch test.
10. A clinician orders a non-cytotoxic crossmatch test using flow cytometry to assess HLA compatibility between a donor and recipient for a heart transplant.