Summary & Overview
CPT 81373: HLA Class I Low/Intermediate Resolution Molecular Test
CPT code 81373 covers a laboratory molecular test that performs low- or intermediate-resolution typing of human leukocyte antigen (HLA) genes for a single Class I locus. This code captures the technical component of HLA Class I genotyping performed using molecular techniques. HLA testing is critical for organ and stem cell transplantation compatibility, donor selection, and certain immunogenetic evaluations, making accurate coding and billing important for patient matching and laboratory reimbursement nationally.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines typical payment and coverage considerations across major national payers, where available, and identifies common clinical contexts in which CPT code 81373 is used.
Readers will find an overview of the code’s clinical purpose and service setting, payer coverage scope, common modifiers and billing considerations, and related procedural context. Where specific benchmark or policy data is not provided in the input, the text notes that information is not available. The piece is written for a national audience interested in clinical coding, laboratory services, and payer coverage patterns for HLA Class I molecular testing.
Billing Code Overview
CPT code 81373 describes a technical laboratory assay that performs a low- or intermediate-resolution assessment of human leukocyte antigen (HLA) genes for one Class I locus using molecular techniques. The service involves laboratory processing and analysis of patient specimens to determine HLA Class I genotypes at a resolution level used for transplantation matching, donor screening, or disease association testing.
Service type: Laboratory molecular diagnostic test (technical component)
Typical site of service: Clinical laboratory or hospital laboratory
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 32-year-old patient being evaluated for organ transplantation requires HLA typing to assess donor–recipient compatibility. A clinician orders low- or intermediate-resolution molecular testing for a single Class I HLA locus (HLA-A, HLA-B, or HLA-C). The specimen (peripheral blood or buccal swab) is collected in the outpatient infusion center or transplant clinic and sent to the molecular pathology laboratory. The laboratory analyst performs the technical component of the assay, including DNA extraction, amplification (e.g., PCR-based methods), and allele detection appropriate for low/intermediate resolution. Results are reviewed by the laboratory director or molecular pathologist and reported to the transplant team to inform donor selection and immunologic risk assessment. Typical site of service is an outpatient molecular diagnostics laboratory or hospital-based clinical laboratory supporting transplant services.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no other modifier applies and service is billed normally |
26 | Professional component | Use when reporting only the professional (interpretation) component if applicable in split billing arrangements |