Histocompatibility Testing Form
Please answer all questions to determine coverage (0 of 4)
Background for this Policy
Histocompatibility testing involves the matching or typing of the human leucocyte antigen (HLA).
This testing is safe and effective when it is performed on patients:
B. In preparation for bone marrow transplantation;
C. In preparation for blood platelet transfusions (particularly where multiple infusions are involved); or
D. 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. 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.
Walk through this policy with us
Review how this policy can be converted into cited criteria, prior authorization checks, and operational automation.