CPT 86829 HLA Antibody Reimbursement | OpenPayer

Summary & Overview

CPT 86829: HLA Antibody Solid Phase Immunoassay

CPT code 86829 covers a solid phase immunoassay on patient serum to detect antibodies to human leukocyte antigen (HLA), both Class I and Class II. This test is clinically important for transplant compatibility assessment, donor-recipient matching, and monitoring for sensitization that can affect graft outcomes. Nationally, HLA antibody testing is a critical component of transplant programs and immunogenetics laboratories that supports patient safety and organ allocation decisions.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines what providers and laboratory managers need to know about coding, expected sites of service, and clinical context for use of 86829.

Readers will learn: a concise clinical description of the procedure, the typical site of service and laboratory setting, and the scope of payers addressed. This summary also highlights common operational contexts for the test (pre-transplant evaluation and post-transplant monitoring). Data not available in the input is noted where applicable; this publication does not provide payer-specific reimbursement rates, local coverage determinations, or ICD-10 guidances beyond noting that such details are not provided in the input.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare86829CPTHLA antibodyimmunoassaytransplantationclinical laboratoryserologyimmunogenetics

Billing Code Overview

CPT code 86829 describes a solid phase immunoassay performed on patient serum to detect the presence or absence of antibodies to human leukocyte antigen (HLA), Class I or Class II. This laboratory service is a specialized immunologic test that assesses HLA antibody status, typically used in transplant evaluation, organ allocation, and monitoring for alloimmune sensitization.

Service Type: Laboratory — Immunology / Serology

Typical Site of Service: Clinical laboratory or hospital laboratory (outpatient or inpatient specimen processing)

Clinical & Coding Specifications

Clinical Context

A 48-year-old patient with end-stage renal disease is evaluated in the transplant clinic prior to a deceased-donor kidney transplant. The transplant team orders HLA antibody testing to identify pre-formed anti-human leukocyte antigen (HLA) Class I and Class II antibodies in the patient’s serum. A phlebotomy draw is performed; the specimen is delivered to the immunology laboratory. A laboratory analyst performs a solid phase immunoassay (single-antigen bead or panel-reactive antibody assay) to detect the presence or absence of HLA-specific antibodies. Results inform crossmatch decisions, organ allocation priority (calculated panel-reactive antibody), and post-transplant immunosuppressive planning. Typical workflow: specimen accessioning → serum separation → assay setup and incubation → instrument readout and interpretation → result reporting to the transplant team and electronic medical record. Typical site of service: hospital-based transplant center, hospital outpatient laboratory, or reference immunology laboratory.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional interpretation/analysis portion, separate from the technical laboratory component.
`TC`

CPT 86812: HLA Class I Single Antigen Serologic Test

CPT-86805-TRANSPLANT-LYMPHOCYTE-CROSSMATCH-COMPATIBILITY-TEST

CPT 86805: Donor Lymphocyte–Recipient Serum Crossmatch Test

CPT-86825-HLA-CROSSMATCH-FLOW-CYTOMETRY

CPT 86825: HLA Crossmatch by Non-Cytotoxic Method (e.g., Flow Cytometry)

CPT-86808-HLA-PERCENT-REACTIVE-ANTIBODY-SCREENING

CPT 86808: HLA Percent Reactive Antibody Screening

CPT-86831-HLA-CLASS-II-ANTIBODY-SOLID-PHASE-IMMUNOASSAY

CPT 86831: HLA Class II Antibody Solid Phase Immunoassay

CPT-86826-HLA-CROSSMATCH-FLOW-CYTOMETRY-BASED-COMPATIBILITY-TEST

CPT 86826: HLA Crossmatch by Flow Cytometry or Other Non-Cytotoxic Method

CPT-86813-HLA-CLASS-I-SEROLOGIC-TYPING

CPT 86813: HLA Class I Serologic Antigen Typing

CPT-86835-HLA-CLASS-II-ANTIBODY-SOLID-PHASE-IMMUNOASSAY

CPT 86835: HLA Class II Antibody Solid Phase Immunoassay

CPT-86828-HLA-ANTIBODY-SOLID-PHASE-IMMUNOASSAY

CPT 86828: HLA Antibody Solid Phase Immunoassay

CPT-86849-UNLISTED-IMMUNOLOGY-PROCEDURE

CPT 86849: Unlisted Immunology Procedure

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Taxonomy Code	Specialty	Notes
352400000X	Transplant Immunology	Laboratory specialists or clinical immunologists who oversee HLA testing.
207L00000X	Allergy & Immunology	Physicians interpreting antibody significance in transplant or immunologic disease contexts.
207P00000X	Pathology	Clinical pathologists who supervise laboratory operations and result validation.
363L00000X	Clinical Laboratory	Medical technologists and laboratory directors performing and supervising immunoassays.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z94.0`	Kidney transplant status	Indicates transplant candidate or recipient monitoring where HLA antibody testing guides compatibility and management.
`Z94.1`	Heart transplant status	HLA antibody testing is relevant for heart transplant compatibility and post-transplant monitoring.
`Z48.21`	Encounter for aftercare following kidney transplant	Used when monitoring for rejection risk via HLA antibody surveillance.
`T86.10`	Unspecified complication of kidney transplant	Positive HLA antibodies may indicate antibody-mediated rejection contributing to transplant complications.
`Z76.89`	Other persons encountering health services for specific procedures and healthcare reasons	Used for pre-transplant evaluation including immunologic testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86829`	Solid phase HLA antibody assay, Class I or Class II (performed to detect HLA antibodies)	Primary code describing the solid phase immunoassay used to detect HLA Class I or II antibodies.
`86816`	HLA tissue typing, serologic method; Class I (A,B) and Class II (DR)	Performed earlier in donor/recipient matching workflows; HLA typing complements antibody testing.
`86818`	HLA tissue typing, molecular method (e.g., PCR-based)	Molecular HLA typing of donor or recipient performed as part of compatibility assessment alongside antibody detection.
`86363`	Antibody; immunoassay for infectious agent (e.g., single analyte)	Other immunoassay techniques in the lab; included as a related laboratory immunoassay methodology.
`86829`	Solid phase HLA antibody assay (repeat entry for procedural context)	Often ordered serially to monitor sensitization pre- and post-transplant; used with crossmatch testing.

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