Summary & Overview
CPT 81267: Post‑Transplant STR Chimerism (Engraftment) Analysis
CPT code 81267 identifies an STR-based laboratory test performed after cellular transplantation to compare a post–transplant specimen (commonly bone marrow or peripheral blood) with the original donor specimen tested in 81265. The assay assesses chimerism or engraftment status and can detect recurrence of disease; it is specified to be performed without lineage–specific subset analysis. Nationally, this code matters because post–transplant monitoring guides clinical decision-making for hematopoietic stem cell transplant recipients and drives utilization in hospital and reference laboratory settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for chimerism testing, the service and typical sites of service, and the practical implications for billing and claims processing. The publication also summarizes common modifiers associated with laboratory services and indicates where input data were not available. The content is intended for national audiences including laboratory managers, billing professionals, and policy analysts seeking clear guidance on the clinical role and billing identity of CPT code 81267.
Billing Code Overview
CPT code 81267 describes a laboratory post–transplant chimerism (engraftment) analysis that compares short tandem repeat (STR) markers from a post–transplant specimen, such as bone marrow, with the initial donor specimen tested in 81265. The test determines whether the transplant has achieved chimerism/engraftment or whether underlying disease has recurred, and is performed without lineage–specific cell subset testing.
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Service type: Molecular diagnostic laboratory test (STR-based chimerism analysis)
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Typical site of service: Clinical laboratory processing post–transplant specimens (for example, hospital or independent reference laboratory receiving bone marrow or peripheral blood specimens)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient undergoes allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia. Post-transplant, the transplant team orders molecular chimerism testing to assess engraftment and detect early relapse. A peripheral blood or bone marrow specimen is collected at scheduled intervals (for example, Day +30, +60, +100 and as clinically indicated). The laboratory performs short tandem repeat (STR) analysis, comparing STR markers from the post-transplant specimen to the original donor specimen tested previously. Results quantify the proportion of donor versus recipient DNA (overall chimerism) to determine whether engraftment is complete, mixed, or declining, which can prompt clinical interventions such as immunosuppression adjustment, donor lymphocyte infusion, or further diagnostic evaluation. Typical sites of service include hospital inpatient units, outpatient infusion centers, and reference molecular laboratories. The service type is anatomic/molecular laboratory testing (technical component) without lineage-specific cell subset testing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When a physician or qualified provider interprets and signs out the molecular test separate from the laboratory's technical work |
TC |