Billing and Coding: MolDX: HLA Testing for Transplant Histocompatibility

HLA testing for transplant histocompatibility is not payable as a stand-alone laboratory service; when performed for covered solid organ transplants or as part of allogeneic stem cell transplant acquisition by an approved transplant center, HLA testing is included in the organ or stem cell acquisition payment. Claims must be billed per CMS Pub 100-04 (Ch.3 §90) and 42 CFR Part 412 (reasonable cost basis for listed organs; bundled MS-DRG/OPPS APC payment for allogeneic stem cell transplants), and separate payment for these acquisition services will be denied.

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

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