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The CPT® Code 86807 refers to a laboratory test specifically designed for serum screening of cytotoxic percent reactive antibody (PRA) using a standard method. This test is crucial in the context of organ transplantation, as it assesses the presence of human leukocyte antigen (HLA) antibodies in the serum of the organ recipient. The detection of these antibodies is vital because they can trigger an immune response that may lead to hyperacute rejection of the transplanted organ. Human leukocyte antigens are glycoproteins found on the surface of cell membranes, and they play a significant role in the body's immune response. There are two main classes of HLA antigens: Class I antigens, which primarily activate killer T-cells, and Class II antigens, which activate helper T-4 cells, macrophages, and B-cells. The screening process involves mixing the recipient's serum with leukocytes from a donor pool and employing various testing methods, such as flow cytometry, enzyme-linked immunosorbent assay (ELISA), complement-dependent cytotoxicity, or anti-human globulin augmentation. The outcome of this test is expressed as a percentage of reactions observed within the sample panel; a higher percentage indicates an increased risk of organ rejection for the patient. For instances where a quicker screening method is utilized, the CPT® Code 86806 should be applied instead.
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The serum screening for cytotoxic percent reactive antibody (PRA) is indicated in the following scenarios:
The procedure for conducting the serum screening for cytotoxic PRA involves several detailed steps:
After the serum screening for cytotoxic PRA is completed, the results are analyzed and reported to the healthcare provider. The findings will guide the medical team in determining the compatibility of the organ donor with the recipient. If a high percentage of cytotoxicity is detected, further evaluations and considerations for alternative donor options may be necessary to minimize the risk of rejection. The recipient may also be monitored for any signs of immune response or complications related to the transplant process.
| Short Descr | CYTOTOXIC ANTIBODY SCREENING | Medium Descr | SERUM SCREENING % REACTIVE ANTIBODY STANDRD METH | Long Descr | Serum screening for cytotoxic percent reactive antibody (PRA); standard method | 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 | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 2 | CCS Clinical Classification | 235 - Other Laboratory |
| 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. | 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. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd |
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| Pre-1990 | Added | Code added. |