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The HLA Class II typing, low resolution (CPT® Code 81377) is a laboratory procedure that focuses on identifying specific antigen equivalents associated with the human leukocyte antigen (HLA) system. The HLA system is a critical component of the major histocompatibility complex (MHC), which plays a vital role in the immune system by facilitating self-recognition. This means that the MHC helps the body distinguish its own cells and tissues from foreign substances, including pathogens and nonself cells. HLA molecules are located on the short arm of chromosome 6 and are essential for the normal functioning of the immune response. HLA Class II molecules are particularly important as they are involved in initiating immune responses. They consist of five loci: DR, DQ, DP, DM, and DO, with DR, DQ, and DP being the most clinically significant. Each locus can have multiple variants known as alleles, which are designated by the locus name followed by an asterisk (*) and a series of digits that provide specific information about the allele. For example, the designation DRB1*15 indicates a specific allele within the DRB1 locus. The low resolution typing of HLA Class II antigens is performed using various molecular techniques, including polymerase chain reaction (PCR) methods. One such method is PCR sequence specific priming (SSP), which utilizes a set of primer pairs to amplify specific groups of alleles. This low resolution testing is designed to identify antigen equivalents rather than the precise allele sequence. It is important to note that low resolution typing can be conducted using test kits or semi-automatic systems, and it is distinct from higher resolution typing, which provides more detailed genetic information. CPT® Code 81377 specifically applies to the testing of a single HLA Class II antigen equivalent, such as DRB1*15, allowing for targeted analysis of the immune response related to that specific antigen.
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The HLA Class II typing, low resolution (CPT® Code 81377) is indicated for various clinical scenarios where understanding an individual's HLA profile is essential. The following conditions and situations may warrant this testing:
The procedure for HLA Class II typing, low resolution (CPT® Code 81377) involves several key steps to ensure accurate identification of antigen equivalents. The following outlines the procedural steps:
After the HLA Class II typing procedure, the patient may not require any specific post-procedure care, as the process is minimally invasive. However, it is essential to communicate the results to the patient and relevant healthcare providers. The results can take several days to process, and patients should be informed about the timeline for receiving their results. Additionally, healthcare providers may need to discuss the implications of the findings, especially in the context of transplant compatibility, autoimmune disorders, or genetic counseling. Follow-up appointments may be necessary to address any questions or to plan further management based on the HLA typing results.
| Short Descr | HLA II TYPE 1 AG EQUIV LR | Medium Descr | HLA II LOW RESOLUTION ONE ANTIGEN EQUIVALENT EA | Long Descr | HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 2 | CCS Clinical Classification | 234 - Pathology |
| 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | GA | Waiver of liability statement issued as required by payer policy, individual case | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2012-01-01 | Added | Added |
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