How To Use CPT Code 86833

CPT 86833 describes the process of identifying specific antibodies to Class II human leukocyte antigens (HLA) using a high-definition method. 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 86833?

CPT 86833 can be used to identify specific antibodies to Class II 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 determine the presence of specific HLA Class II antibodies.

2. Official Description

The official description of CPT code 86833 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 II.’

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 II antigens.
3. A marker, such as a fluorescent immunoglobulin, is added to the mixture to indicate an antibody/antigen reaction.
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 which specific HLA Class II antibodies are present in the patient serum.

4. Qualifying circumstances

CPT 86833 is used when clinicians order this test to further identify possible compatibility between a donor and recipient for solid organ or bone marrow transplants. It is typically ordered following a tissue typing test that indicates compatible HLA antigens and an antibody screening that demonstrates high levels of HLA Class II antibodies. This test helps identify specific HLA Class II 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 86833

CPT code 86833 should be used when a lab analyst performs a high-definition qualitative panel for the identification of antibody specificities to HLA Class II antigens. It is used to determine the presence of specific HLA Class II antibodies in patient serum.

6. Documentation requirements

To support a claim for CPT 86833, the lab analyst must document the following information:

• Patient’s serum used for the test
• Specific HLA Class II antigens tested
• The high-definition method used for the test
• Results of the antibody/antigen reaction
• Specific HLA Class II antibodies identified in the patient serum
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86833, ensure that the test is performed by a lab analyst using a high-definition method. Do not report flow cytometry method codes in addition to this code. It is important to distinguish this code for qualitative high-definition HLA Class II antibody specificity test from other related codes. If the analyst needs to remove interfering antibodies from the serum and re-run the test, report this code once for the initial test and once for the test following removal of the interfering antibody.

8. Historical information

CPT 86833 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 II antigens using patient serum.
2. A patient undergoes a solid organ transplant, and the lab analyst uses CPT 86833 to identify specific HLA Class II antibodies in their serum to ensure compatibility with the donor.
3. A clinician orders CPT 86833 periodically for a transplant recipient who has been waiting a long time for a matching organ to monitor any changes in antibody status.
4. After a transplant, the lab analyst performs CPT 86833 to determine if the recipient has developed new antibodies to the donor tissue, which could indicate possible problems with transplant rejection.
5. A lab analyst uses CPT 86833 to identify specific HLA Class II antibodies in patient serum for research purposes.
6. A patient with a history of blood transfusions undergoes CPT 86833 to determine if they have developed HLA Class II antibodies.
7. A lab analyst performs CPT 86833 to identify specific HLA Class II antibodies in patient serum for diagnostic purposes.
8. A clinician orders CPT 86833 to assess the risk of transplant rejection in a potential organ recipient.
9. A lab analyst uses CPT 86833 to identify specific HLA Class II antibodies in patient serum to guide treatment decisions.
10. A patient with a history of multiple pregnancies undergoes CPT 86833 to determine if they have developed HLA Class II antibodies.