Summary & Overview
CPT 81111: HPA-9 (V837M) Allele Analysis, Laboratory Technical Component
CPT code 81111 covers the laboratory technical performance of a molecular diagnostic assay to analyze the two common alleles of Human Platelet Antigen 9 (HPA–9), also known as V837M, using specimens such as blood or amniotic fluid. This code captures the technical component of an allele-specific genetic test used in transfusion medicine, maternal-fetal risk assessment, and immunohematology contexts. Nationally, accurate coding of genetic assays like this supports appropriate tracking of laboratory utilization and reimbursement for specialized molecular diagnostics.
Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of what readers will learn: clinical context for HPA–9 allele testing, how the code is described and billed, typical sites of service, and which payers are commonly involved. Where available, benchmarking data and recent policy updates affecting molecular genetic test coverage are summarized to give readers operational and billing context.
Readers will gain a clear sense of the clinical purpose of the test, the billing construct for the technical laboratory component captured by CPT code 81111, and the payer landscape relevant to coverage discussions. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 81111 describes a laboratory technical procedure for analyzing the two common alleles of Human Platelet Antigen 9 (HPA–9), also called V837M, using a biological specimen such as blood or amniotic fluid. This is a molecular diagnostic test performed by a lab analyst to determine allele status for HPA–9.
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Service type: Molecular diagnostic laboratory testing (genetic allele analysis)
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Typical site of service: Clinical laboratory or hospital laboratory processing blood or amniotic fluid specimens
Clinical & Coding Specifications
Clinical Context
A typical patient is a pregnant woman or a transfusion recipient undergoing targeted platelet antigen genotyping to identify alleles of Human Platelet Antigen 9 (HPA‑9, V837M). Specimens are usually peripheral blood from the patient, paternal sample, or fetal amniotic fluid. Clinical workflow: a clinician orders testing when immune thrombocytopenia, suspected neonatal alloimmune thrombocytopenia (NAIT), or platelet transfusion refractoriness is present. The specimen is collected in an appropriate anticoagulated tube and sent to a molecular diagnostic laboratory. A laboratory analyst performs the technical assay to detect the two common HPA‑9 alleles; results are reported to the ordering clinician and incorporated into fetal risk assessment, donor selection for platelet transfusion, or counseling regarding NAIT risk. Typical site of service: hospital outpatient laboratory, independent reference laboratory, or hospital inpatient laboratory when testing is required for acute neonatal or prenatal care.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing for physician interpretation or consultation separate from the lab technical component (rare for molecular lab tests). |
TC | Technical component |