Summary & Overview
CPT 86834: HLA Class I Antibody Solid Phase Immunoassay
CPT code 86834 denotes a laboratory immunoassay that quantifies patient serum antibodies to specific Class I human leukocyte antigens (HLA). This test is a critical component of transplant evaluation and post-transplant immune monitoring, informing compatibility assessments and risk stratification for antibody-mediated rejection. Nationally, HLA antibody testing supports organ allocation, transplant decision-making, and longitudinal patient management.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes coverage and billing practices across major payers, focusing on clinical context, common sites of service, coding considerations, and available benchmarks where provided. Data not available in the input is noted where applicable.
Readers will learn the clinical purpose and typical delivery setting for CPT code 86834, how it fits into transplant-related laboratory workflows, and which stakeholders commonly cover the service. The report also outlines the types of benchmarks and policy updates to examine (coverage criteria, site-of-service patterns, and utilization trends) and provides a concise reference for coding and clinical teams engaging with HLA Class I antibody testing.
Billing Code Overview
CPT code 86834 describes a solid phase immunoassay performed on patient serum to quantify antibodies against specific Class I human leukocyte antigens (HLA). The procedure is a laboratory-based immunology test used to detect and measure anti-HLA Class I antibodies, often in the context of transplant compatibility assessment, antibody monitoring, or immunologic risk evaluation.
Service Type: Laboratory — Immunoassay / Transplant Immunology
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 45-year-old female kidney transplant recipient presents for routine post-transplant immunologic monitoring and for evaluation of declining graft function. Her transplant nephrologist orders donor-specific antibody testing to quantify recipient serum antibodies directed against Class I human leukocyte antigens (HLA-A, HLA-B, HLA-C) to assess for antibody-mediated rejection risk. In the clinical workflow: the phlebotomy team collects a serum sample, labels it with patient and donor identifiers, and sends it to the hospital immunology laboratory. A laboratory analyst performs a solid-phase immunoassay to quantify specific anti–HLA Class I antibodies. The lab documents assay results, including mean fluorescence intensity or equivalent quantitative values, interprets positive/negative thresholds, and reports results to the ordering clinician. Results inform decisions about immunosuppression adjustment, further confirmatory testing, or protocol biopsies as clinically appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When only the professional component of the test (interpretation) is billed separate from technical component |
TC | Technical component |