Summary & Overview
CPT 86825: HLA Crossmatch by Non-Cytotoxic Method (e.g., Flow Cytometry)
CPT code 86825 represents an HLA crossmatch laboratory test that assesses compatibility between donor lymphocytes and an initial recipient serum sample using non-cytotoxic methods such as flow cytometry. This assay is clinically important for transplantation and transfusion planning because it detects donor-specific antibodies and cellular interactions that predict risk of graft rejection or transfusion reactions. Nationally, accurate reporting of crossmatch testing supports clinical decision-making and appropriate billing for complex immunogenetics services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose and service setting for CPT code 86825, along with what to expect in benchmarking and policy contexts where available. The publication covers typical reimbursement considerations for laboratory immunogenetics, common clinical scenarios prompting testing, and operational settings where the service is performed. Data not available in the input includes detailed payer-specific reimbursement rates, associated taxonomies, and ICD-10 diagnoses. The piece is intended as a national-level reference on the clinical and billing identity of CPT code 86825.
Billing Code Overview
CPT code 86825 describes a laboratory HLA crossmatch test in which a lab analyst evaluates human leukocyte antigen (HLA) compatibility by testing donor lymphocytes against an initial recipient serum sample or dilution using methods other than cytotoxic response, such as flow cytometry. This service identifies immunologic compatibility between donor and recipient prior to transplantation or transfusion-related procedures.
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Service type: Immunogenetics laboratory testing (HLA compatibility crossmatch)
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Typical site of service: Hospital immunology or transfusion medicine laboratory, independent clinical laboratory, or transplant center laboratory
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves a patient being evaluated for hematopoietic stem cell transplantation or a solid-organ transplant where HLA compatibility between donor lymphocytes and recipient serum is critical. A transplant coordinator orders an HLA crossmatch using flow cytometry after initial HLA typing to assess the presence of recipient anti-donor antibodies. The lab receives a donor lymphocyte sample and the recipient’s serum; a histocompatibility laboratory technologist prepares cell suspensions, incubates recipient serum with donor lymphocytes, and runs a flow cytometry–based crossmatch. Results document either a positive or negative crossmatch and antibody strength, which are reported back to the transplant team to guide donor selection and perioperative immunologic management. Typical sites of service include hospital-based histocompatibility laboratories, independent reference immunology laboratories, and transplant center laboratories. The patient is typically an adult or pediatric candidate for bone marrow, stem cell, or organ transplantation, often with ICD-10 diagnoses related to end-stage organ disease or hematologic malignancy leading to the need for transplant evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Used when billing only the professional interpretation component by the pathologist/clinical laboratory director. |