Billing and Coding: MolDX: HLA Testing for Transplant Histocompatibility

HLA testing for transplant histocompatibility is not payable as a standalone laboratory service; it is included in organ acquisition costs for covered solid organ transplants and included in MS-DRG/APC prospective payments for allogeneic stem cell transplants. Approved transplant centers must bill these services as acquisition services per CMS billing manuals and CFR rules; separate coverage for non‑transplant HLA tests is determined by specific LCDs (e.g., L38335 for CPT 81381 and L36551 for CPT 81383).

"HLA testing performed as part of solid organ acquisition services for covered transplants (kidney, heart, lung, heart/lung, liver, pancreas, pancreas/kidney, intestinal/multi-visceral) is covered a..."

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