Summary & Overview
CPT 86828: HLA Antibody Solid Phase Immunoassay
CPT code 86828 denotes a laboratory immunoassay that tests patient serum for antibodies to human leukocyte antigen (HLA) Class I and II. This assay is important for transplant evaluation, alloimmunization assessment, and immunologic risk stratification, making it a nationally relevant diagnostic service in transplant centers and clinical laboratories. The code represents a specialized immunology test that can influence clinical decision-making around donor compatibility and post-transplant monitoring.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for HLA antibody testing, typical sites where the service is performed, and common operational considerations for billing and coding. The publication also outlines what to expect in payer coverage patterns, common modifier usage (listed separately), and areas where policy updates frequently occur for complex laboratory testing.
The report provides benchmarks and practical reference points for utilization and reimbursement trends at a national level, summarizes relevant billing nuances for CPT code 86828, and highlights implications for laboratory workflows and transplant programs. Data not available in the input will be identified where applicable.
Billing Code Overview
CPT code 86828 describes a solid phase immunoassay performed on patient serum to detect antibodies to human leukocyte antigens (HLA), Class I and Class II. The procedure identifies the presence or absence of HLA-specific antibodies by analyzing a patient’s serum against purified HLA antigens in a laboratory setting.
Service Type: Laboratory — immunology/serology testing
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 46-year-old woman with end-stage renal disease is being evaluated for kidney transplantation. The transplant center orders HLA antibody testing to assess donor-specific antibodies and sensitization status prior to listing and before a planned transplant. A phlebotomy technician collects a serum specimen and sends it to the hospital reference immunology laboratory. A clinical laboratory scientist performs a solid-phase immunoassay using patient serum to detect antibodies to HLA Class I and II antigens (CPT 86828). Results are reported in the electronic medical record and used by the transplant immunology team to determine crossmatch risk, guide donor selection, and inform desensitization strategies. Typical site of service is an outpatient laboratory or hospital clinical immunology lab; specimens may originate from outpatient transplant clinics, dialysis units, or inpatient wards. Turnaround time is usually 24–72 hours depending on workflow and urgency.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use if billing only the professional interpretation component when separate technical component is billed by another entity. |
TC |