CPT 81376 HLA Class II Typing Reimbursement | OpenPayer

Summary & Overview

CPT 81376: HLA Class II Typing, Low/Intermediate-Resolution Technical

CPT code 81376 covers the technical laboratory component for low- or intermediate-resolution molecular assessment of human leukocyte antigen (HLA) genes at one Class II locus. This code is used for laboratory processing and analysis when HLA Class II typing is required for transplant compatibility, immunogenetics evaluations, or other clinical indications where class II allele group identification is sufficient.

Nationally, HLA testing supports transplant matching, donor selection, and certain disease risk assessments, making accurate coding and reimbursement important for labs and providers. Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. When present in a claim, CPT code 81376 identifies the technical component of molecular HLA Class II testing performed at clinical or hospital laboratories.

Readers will find benchmarks and context on service utilization and coding practice, relevant clinical context about HLA Class II testing, and notes on payer coverage patterns and policy considerations where available. Data not available in the input will be identified as such.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare81376CPTHLA typingmolecular diagnosticslaboratorytransplant compatibilityclinical laboratoryClass II HLAtechnical component

Billing Code Overview

CPT code 81376 describes a technical laboratory test that performs low- or intermediate-resolution molecular assessment of human leukocyte antigen (HLA) genes for a single Class II locus. The service involves laboratory processing and analysis using molecular techniques to determine HLA Class II typing at a resolution level used for clinical matching and immune compatibility assessment.

Service Type: Laboratory — Molecular HLA Class II typing (technical component)

Typical Site of Service: Clinical laboratory or hospital laboratory

Clinical & Coding Specifications

Clinical Context

A 32-year-old patient evaluated for kidney transplantation is referred for HLA typing to assess donor-recipient compatibility. The ordering clinician is a transplant nephrologist who requests low- or intermediate-resolution molecular testing of a single Class II HLA locus (for example HLA-DR or HLA-DQ) to inform panel reactive antibody interpretation and organ allocation. A phlebotomy nurse collects a peripheral blood sample and sends it with the requisition to the molecular diagnostics laboratory. The laboratory technologist performs nucleic acid extraction and runs the appropriate molecular assay for 81376 (low/intermediate resolution assessment of one Class II locus). Results are reviewed and finalized by a qualified laboratory director, and the report is returned to the transplant team. Typical sites of service include an independent clinical molecular laboratory, hospital-based clinical laboratory, or an academic medical center molecular diagnostics lab. The service is technical in nature and is billed for the laboratory test component of HLA Class II typing using molecular techniques.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting the physician/clinical interpretation and report separate from the laboratory technical component (rare for purely technical lab codes).

CPT 81378: High-Resolution HLA Class I and II Molecular Typing

CPT-81382-HLA-HIGH-RESOLUTION-CLASS-II-TECHNICAL

CPT 81382: HLA High-Resolution Molecular Typing, One Class II Locus

CPT-81372-HLA-CLASS-I-LOW-INTERMEDIATE-RESOLUTION-TYPING

CPT 81372: HLA Class I Low/Intermediate-Resolution Molecular Typing

CPT-81383-HIGH-RESOLUTION-HLA-CLASS-II-ALLELE-TESTING

CPT 81383: High-Resolution HLA Class II Allele Technical Test

CPT-81379-HLA-CLASS-I-HIGH-RESOLUTION-TYPING

CPT 81379: High-Resolution HLA Class I Typing

CPT-81375-HLA-CLASS-II-LOW-INTERMEDIATE-RESOLUTION-TYPING

CPT 81375: HLA Class II Low/Intermediate-Resolution Molecular Typing

CPT-81377-HLA-CLASS-II-ALLELE-GROUP-TYPING-LOW-INTERMEDIATE-RESOLUTION

CPT 81377: HLA Class II Allele Group Typing, Low/Intermediate Resolution

CPT-81381-HLA-HIGH-RESOLUTION-CLASS-I-ALLELE-TESTING

CPT 81381: HLA High-Resolution Test for One Class I Allele

CPT-81370-HLA-CLASS-I-II-LOW-INTERMEDIATE-RESOLUTION-TESTING

CPT 81370: HLA Class I and II Low/Intermediate-Resolution Molecular Typing

CPT-81373-HLA-CLASS-I-LOW-INTERMEDIATE-RESOLUTION

CPT 81373: HLA Class I Low/Intermediate Resolution Molecular Test

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Taxonomy Code	Specialty	Notes
207Q00000X	Clinical Molecular Genetics Laboratory	Laboratory specialty performing molecular HLA testing.
207L00000X	Clinical Laboratory	General clinical laboratory taxonomy commonly billing these tests.
208000000X	Pathology	Pathologists or laboratory directors who oversee and interpret molecular diagnostics.
208100000X	Hematology/Oncology	Hematology specialists frequently coordinate HLA testing for transplant patients.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86850`	Tissue typing; HLA antibody, lymphocytotoxic (assay)	Serologic HLA antibody testing often performed in parallel with molecular HLA typing for transplant compatibility assessment.
`86821`	Crossmatch, lymphocytotoxic, non-donor specific antibody (complement-dependent)	Crossmatch studies are performed as part of pre-transplant compatibility testing alongside HLA typing.
`81479`	Unlisted molecular pathology procedure	Used when testing falls outside defined molecular CPT codes or for novel/expanded HLA assays not captured by `81376`.
`88381`	Consultation and laboratory oversight (interpretation)	Pathologist or laboratory director interpretation and supervision related to molecular testing results.
`36415`	Collection of venous blood by venipuncture	Specimen collection code commonly billed or documented when obtaining sample for HLA molecular testing.

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