CPT® Code 81380

Official Description

HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), each

Common Language Description

The HLA Class I typing, high resolution (CPT® Code 81380) is a specialized laboratory procedure that focuses on identifying specific alleles or allele groups within one of the three major loci of the HLA Class I system, which includes HLA-A, HLA-B, or HLA-C. The human leukocyte antigen (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, such as pathogens and non-self cells. The HLA molecules are located on the short arm of chromosome 6 and are essential for various immune responses, including the defense against diseases, organ transplant compatibility, and susceptibility to certain cancers and autoimmune disorders. HLA Class I typing is particularly important because it provides detailed information about the genetic variations (alleles) present at specific loci. Each locus can have multiple variants, and these are designated using a specific nomenclature that includes the locus name followed by an asterisk and a series of digits that indicate the allele group and specific allele. For example, HLA-B*08:01 indicates a specific allele within the HLA-B locus. High resolution typing is achieved through molecular techniques, such as polymerase chain reaction (PCR), which amplifies DNA to identify these alleles with precision. This level of detail is crucial for applications such as organ transplantation, where matching donor and recipient HLA types can significantly impact the success of the transplant. CPT® Code 81380 is specifically used when high resolution testing is performed for a single HLA Class I locus, distinguishing it from other codes that encompass broader testing or multiple loci.

1. Indications

The HLA Class I typing, high resolution (CPT® Code 81380) is indicated for various clinical scenarios where precise identification of HLA alleles is necessary. The following conditions and situations may warrant this procedure:

Organ Transplantation: To assess compatibility between donor and recipient, reducing the risk of transplant rejection.
Bone Marrow Transplantation: To identify suitable donors for hematopoietic stem cell transplants, ensuring better match and outcomes.
Autoimmune Diseases: To evaluate susceptibility to certain autoimmune conditions that may be influenced by specific HLA alleles.
Infectious Disease Response: To understand individual immune responses to infections, which can vary based on HLA types.
Cancer Susceptibility: To identify genetic predispositions to certain cancers that may be associated with specific HLA alleles.

2. Procedure

The procedure for HLA Class I typing, high resolution (CPT® Code 81380) involves several key steps to ensure accurate identification of alleles at a single locus. The following procedural steps are typically followed:

Step 1: Sample Collection A blood sample or tissue sample is collected from the patient. This sample contains nucleated cells, which are necessary for DNA extraction.
Step 2: Cell Lysis and Protein Digestion The collected sample undergoes cell lysis to break down the cell membranes, followed by protein digestion to remove proteins that may interfere with DNA extraction.
Step 3: DNA Extraction DNA is extracted from the lysed cells using chemical or mechanical methods, isolating the genetic material needed for analysis.
Step 4: Polymerase Chain Reaction (PCR) The extracted DNA is subjected to PCR, a technique that amplifies specific regions of the DNA that correspond to the HLA alleles of interest. This step is crucial for obtaining sufficient DNA for analysis.
Step 5: High Resolution Typing Using PCR sequence specific priming (SSP), a panel of primer pairs is utilized to amplify specific allele groups. This allows for the identification of high-resolution alleles at the selected locus (HLA-A, HLA-B, or HLA-C).
Step 6: Analysis and Reporting The amplified DNA is analyzed to determine the specific alleles present at the chosen locus. The results are then compiled into a report detailing the identified alleles.

3. Post-Procedure

After the HLA Class I typing procedure is completed, the patient may not require any specific post-procedure care, as the process is primarily laboratory-based and does not involve invasive techniques. However, it is essential for healthcare providers to review the results with the patient, especially in the context of organ transplantation or disease susceptibility. The results can guide further clinical decisions, such as the need for additional testing or interventions based on the identified HLA types. Patients should be informed about the implications of their HLA typing results, particularly regarding potential donor-recipient compatibility and any associated health risks. Follow-up consultations may be necessary to discuss the findings and their relevance to the patient's health and treatment options.

Short Descr	HLA I TYPING 1 LOCUS HR
Medium Descr	HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA
Long Descr	HLA Class I typing, high resolution (ie, alleles or allele groups); one locus (eg, HLA-A, -B, or -C), 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.
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.
26	Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
GW	Service not related to the hospice patient's terminal condition
GZ	Item or service expected to be denied as not reasonable and necessary