How To Use CPT Code 86835

CPT 86835 describes the quantification of specific antibodies to Class II human leukocyte antigens (HLA) using a solid phase immunoassay. 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 86835?

CPT 86835 can be used to quantify specific antibodies to Class II human leukocyte antigens (HLA) in patient serum. This code is used when a solid phase immunoassay is performed to determine the level of these antibodies. The test involves mixing patient serum with beads coated with specific HLA Class II antigens and evaluating the antibody/antigen reaction using techniques such as flow cytometry or enzyme-linked immunosorbent assay (ELISA).

2. Official Description

The official description of CPT code 86835 is: ‘Antibody to human leukocyte antigens (HLA), solid phase assays (eg, microspheres or beads, ELISA, Flow cytometry); semi-quantitative panel (eg, titer), HLA Class II.’

3. Procedure

1. The lab analyst collects patient serum and performs a solid phase immunoassay using beads coated with specific HLA Class II antigens.
2. The serum is mixed with the beads at different dilutions, and a marker that becomes visible upon antibody/antigen reaction is added.
3. The lab analyst evaluates the antibody/antigen reaction using techniques such as flow cytometry or ELISA.
4. The level of specific HLA Class II antibodies in the patient serum is quantified based on the results of the immunoassay.

4. Qualifying circumstances

CPT 86835 is typically ordered by clinicians to evaluate the level of specific HLA Class II antibodies in patient serum. This test is often performed to assess if the antibody level is decreasing following desensitization treatment, which helps prevent transplant rejection in patients who have developed antibodies against potential transplant donors.

5. When to use CPT code 86835

CPT code 86835 should be used when there is a need to quantify specific antibodies to Class II human leukocyte antigens (HLA) in patient serum. It is important to note that this code is specifically for semi-quantitative panel testing of HLA Class II antibodies. Other codes should be used for different types of HLA antibody testing.

6. Documentation requirements

To support a claim for CPT 86835, the following documentation is required:

• Patient’s clinical indication for the test
• Specific HLA Class II antigens tested
• Date and time of the test
• Results of the immunoassay, including the level of specific HLA Class II antibodies
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 86835, ensure that the test is performed using a solid phase immunoassay and that the specific HLA Class II antigens are identified. It is important to note that this code should not be reported with flow cytometry method codes or other codes for HLA antibody testing. Additional tips for reporting CPT 86835 may include separate billing for specimen collection using a venipuncture code and distinguishing this code from other HLA antibody testing codes.

8. Historical information

CPT 86835 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 patient undergoes HLA antibody testing to determine the level of specific Class II antibodies in their serum following desensitization treatment for a potential transplant.
2. A clinician orders CPT 86835 to assess if the level of specific HLA Class II antibodies is decreasing in a patient who has developed antibodies against a potential transplant donor.
3. A lab analyst performs a solid phase immunoassay using patient serum to quantify the level of specific HLA Class II antibodies for research purposes.
4. A patient with a history of blood transfusions undergoes HLA antibody testing to identify any antibodies that may complicate future transplant procedures.
5. A clinician orders CPT 86835 to monitor the level of specific HLA Class II antibodies in a patient receiving immunosuppressive therapy.
6. A lab analyst performs a semi-quantitative panel test for specific HLA Class II antibodies in patient serum to determine the compatibility for a potential transplant.
7. A patient with a previous organ transplant undergoes HLA antibody testing to assess the risk of rejection for a subsequent transplant.
8. A clinician orders CPT 86835 to evaluate the level of specific HLA Class II antibodies in a patient with autoimmune disease.
9. A lab analyst performs a solid phase immunoassay to quantify the level of specific HLA Class II antibodies in patient serum for a research study on transplant immunology.
10. A patient with a history of multiple pregnancies undergoes HLA antibody testing to assess the risk of complications in future pregnancies.