How To Use CPT Code 86832

CPT 86832 describes the identification of specific antibodies to Class I human leukocyte antigens (HLA) using a high-definition method. 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 86832?

CPT 86832 can be used to identify the presence of specific antibodies to Class I human leukocyte antigens (HLA) using a high-definition method. This code is used when a lab analyst performs a solid phase immunoassay using patient serum and a high-definition method, such as testing for one antigen per bead, to evaluate the antibody/antigen reaction and report the specific antibodies present in patient serum to specific HLA Class I antigens.

2. Official Description

The official description of CPT code 86832 is: ‘Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), HLA Class I.’

3. Procedure

1. The lab analyst performs a solid phase immunoassay using patient serum and a high-definition method.
2. The patient serum is mixed with beads coated with specific HLA Class I antigens.
3. A marker that becomes visible in the presence of an antibody/antigen reaction is added to the mixture.
4. The lab analyst evaluates the antibody/antigen reaction using a special instrument and process, such as flow cytometry or enzyme-linked immunosorbent assay (ELISA).
5. The lab analyst reports the specific antibodies present in patient serum to specific HLA Class I antigens.

4. Qualifying circumstances

CPT 86832 is typically ordered by clinicians to further identify possible compatibility between donor and recipient for solid organ or bone marrow transplants. It is used when there is a compatible HLA tissue type between the donor and recipient and an antibody screening demonstrates high levels of HLA Class I antibodies. This test helps identify specific HLA Class I antibodies present in recipient blood to donor HLA antigens that may cause transplant rejection despite a good tissue type match.

5. When to use CPT code 86832

CPT code 86832 should be used when a lab analyst performs a high-definition qualitative panel for the identification of antibody specificities to HLA Class I antigens using a solid phase assay method, such as microspheres or beads, ELISA, or flow cytometry. It is typically ordered following a tissue typing test that indicates compatible HLA antigens between the donor and recipient and an antibody screening that demonstrates high levels of HLA Class I antibodies.

6. Documentation requirements

To support a claim for CPT 86832, the lab analyst must document the following information:

• Patient’s serum used for the test
• Specific HLA Class I antigens tested
• Methodology used for the high-definition qualitative panel
• Results of the antibody/antigen reaction
• Report of the specific antibodies present in patient serum to specific HLA Class I antigens

7. Billing guidelines

When billing for CPT 86832, ensure that the test is performed by a lab analyst using a high-definition method for the identification of antibody specificities to HLA Class I antigens. Do not report flow cytometry method codes in addition to this code. It is important to distinguish this code from other codes that represent different methods or levels of specificity in HLA antibody testing. Additional tips for billing may include reporting a separate code for specimen collection and not reporting this code multiple times for removal of interfering antibodies.

8. Historical information

CPT 86832 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs a high-definition qualitative panel for the identification of antibody specificities to HLA Class I antigens using patient serum.
2. A patient with a compatible HLA tissue type for a solid organ transplant undergoes a high-definition antibody specificity test to identify specific HLA Class I antibodies present in their blood.
3. A lab analyst evaluates the antibody/antigen reaction using flow cytometry and reports the specific antibodies present in patient serum to specific HLA Class I antigens.
4. A clinician orders CPT 86832 periodically for a transplant recipient who has been waiting a long time for a matching organ to monitor changes in antibody status.
5. Following a solid organ transplant, a patient undergoes a high-definition antibody specificity test to determine if they have developed new antibodies to the donor tissue, which could indicate possible problems with transplant rejection.