Summary & Overview
CPT 86817: HLA Class II (DR/DQ) Serologic Identification
CPT code 86817 designates a laboratory serologic test to identify multiple human leukocyte antigens (HLA) from HLA Class II antigens, specifically the DR and DQ loci. This test is clinically important for organ and tissue transplant compatibility assessment, immunogenetics research, and certain autoimmune disease evaluations. Nationally, standardized reporting of HLA testing supports transplant allocation, cross-match interpretation, and clinical decision-making across diverse health systems.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Coverage policies and reimbursement for HLA serologic testing vary by payer and clinical indication; payers often reference medical necessity criteria tied to transplantation, graft-versus-host disease evaluation, or specific diagnostic questions.
Readers will learn the clinical scope of CPT code 86817, the typical laboratory setting where the service is performed, and the primary reasons the test matters in clinical pathways. The publication summarizes benchmark considerations, common billing modifiers associated with laboratory services (listed separately), and the broader policy context affecting access and payment. Data not provided in the input—such as payer-specific rates, precise coverage rules, associated taxonomies, and ICD-10 mappings—is identified as unavailable. The content is presented to inform coding, billing workflows, and policy review at a national level.
Billing Code Overview
CPT code 86817 describes a serologic test for identifying multiple human leukocyte antigens (HLA) focused on Class II cell surface antigens, specifically the DR and DQ loci. The procedure involves laboratory analysis by a trained lab analyst to detect multiple HLA specificities from one or more samples.
Service Type: Serologic HLA Class II DR/DQ identification
Typical Site of Service: Clinical laboratory / hospital lab
Data not available in the input for modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific coverage details.
Clinical & Coding Specifications
Clinical Context
A 42-year-old woman undergoing pre-transplant immunologic evaluation presents for serologic human leukocyte antigen (HLA) Class II testing to assess compatibility for a planned kidney transplant from a living donor. The transplant coordinator orders HLA-DR and HLA-DQ serologic testing to identify antigen specificities that may impact donor selection and crossmatch interpretation. A phlebotomy technician collects a blood specimen in the laboratory's required container and sends it to the immunogenetics laboratory.
In the laboratory workflow, a medical laboratory scientist or lab analyst performs serologic assays using typed panels of anti-DR and anti-DQ sera to detect patient HLA antigens. Results are interpreted and reported in the electronic medical record and to the transplant team. The typical site of service is an outpatient hospital laboratory or independent clinical immunology laboratory supporting transplant programs. The procedure informs donor-recipient matching, helps guide further molecular HLA typing if needed, and assists in assessing alloantibody risk prior to transplantation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional interpretation component of the lab test separated from the technical component. |