NCD190.1

 

HISTOCOMPATIBILITY TESTING

 

Effective Date of this Version

• 8/1/1978

 

Benefit Category

• Diagnostic Laboratory Tests.

• Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

 

Item/Service Description

• Histocompatibility testing involves the matching or typing of the human leucocyte antigen (HLA).

 

Indications and Limitations of Coverage

• This testing is safe and effective when it is performed on patients:

o In preparation for a kidney transplant.

o In preparation for bone marrow transplantation.

o In preparation for blood platelet transfusions (particularly where multiple infusions are involved).

o Who are suspected of having ankylosing spondylitis.

• This testing is covered under Medicare when used for any of the indications listed in A, B, and C and if it is reasonable and necessary for the patient.

• It is covered for ankylosing spondylitis in cases where other methods of diagnosis would not be appropriate or have yielded inconclusive results.

o Request documentation supporting the medical necessity of the test from the physician in all cases where ankylosing spondylitis is indicated as the reason for the test.

 

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