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Pediatric Autoimmune Encephalitis Evaluation with Reflexes, CSF

Test Code
18420


CPT Codes
86052, 84182, 86362, 86341, 86255

Includes
Aquaporin-4 (AQP4) Antibody, CBA with Reflex to Titer, CSF
Collapsin Response-Mediator Protein-5 (CRMP5/CV2) Antibody, Line Blot, CSF
Glutamic Acid Decarboxylase (GAD65) Antibody, Line Blot, CSF
MOG Antibody, CBA with Reflex to Titer, CSF
NMDAR1 Antibody, CBA with Reflex to Titer, CSF

If Aquaporin-4 (AQP4) Antibody, CBA is Positive, then Aquaporin-4 (AQP4) Antibody, Titer will be performed at an additional charge (CPT Code(s): 86052).

If MOG Antibody, CBA is Positive, then MOG Antibody, Titer will be performed at an additional charge (CPT Code(s): 86362).

If NMDAR1 Antibody, CBA is Positive, then NMDAR1 Antibody, Titer will be performed at an additional charge (CPT Code(s): 86256).


Preferred Specimen
2 mL CSF collected in a plastic screw-cap vial


Minimum Volume
1.2 mL


Transport Temperature
Room temperature


Specimen Stability
Room temperature: 7 days
Refrigerated: 14 days
Frozen: 21 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Visible particulate matter


Methodology
Cell-based Immunofluorescence Assay • Line Blot

Setup Schedule
Tuesday, Thursday, Saturday All Shifts Report available: 5 Days


Reference Range
AQP4 Ab, CBANegative
CRMP5 (CV2) Ab, LB<11 SI
GAD65 Ab, LB<11 SI
MOG Ab, CBANegative
NMDAR1 Ab, CBANegative
   
   AQP4 Ab, Titer<1:2
   MOG Ab, Titer<1:2
   NMDAR1 Ab, Titer<1:2


Clinical Significance
Causes of autoimmune encephalitis differ between adults and children, largely due to the fact that autoimmune encephalitis in adults is more likely to be due to cancer, but in children more likely to have been caused by a viral infection. This panel will assess the most common causes of autoimmune encephalitis/encephalomyelitis in the pediatric age group.




The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.