|
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
Epilepsy Antibody Evaluation with Reflex to Titer and Line Blot, Serum
Test CodeCPT Codes
86255 (x19), 86052, 86341, 83519 (x2), 86596 (x2)
Includes
Initial panel consits of: Epilepsy Ab Screen Tissue IFA, AMPAR1, AMPAR2, Aquaporin 4, DPPX, GABAbR, NMDAR1, CASPAR2, LGI1, Ganglionic AChR, VGCC N-Type, VGCC P/Q-Type, and VGKC.
1) A line blot consisting of 10 analytes will be performed at an additional charge (CPT code(s): 84182 x10) as a reflex for tissue mosaic IFA suggesting one or more of the analytes on the line blot: ANNA1 (Hu), ANNA2 (Ri), PCA1 (Yo), Ma2/Ta, CV2 (CRMP5), Amphiphysin, AGNA1 (SOX1), GAD65, DNER, and Zic4. If the tissue mosaic pattern suggests ANNA3, then titer will be performed at an additional charge (CPT code(s): 86256).
2) If the tissue mosaic pattern suggests PCA-2, then titer will be performed at an additional charge (CPT code(s): 86256).
3) If the tissue mosaic IFA suggests PCA-Tr (DNER) and Western Blot shows DNER negative and Yo negative, then cell based assay IFA for DNER will be performed at an additional charge (CPT code(s): 86255).
a. If DNER CBA is positive, then titer will be performed at an additional charge (CPT code(s): 86256).
4) If the tissue mosaic IFA suggests myelin antibody, then
a. Myelin antibody IFA titer will be performed at an additional charge (CPT code(s): 86256).
b. Myelin Associated Glycoprotein (MAG) Antibody, in turn reflexing to MAG-SGPG and MAG ELISA for quantitation, will be performed at an additional charge (CPT code(s): 83520 x2).
5) If the Mosaic CBA is positive for any given analyte (NMDAR1, AMPAR1, AMPAR2, GABA-B Receptor, LGI-1, CASPR2), and the individual CBAs DPPX and Aquaporin 4 antibody, then that analyte will be titered at an additional charge (CPT code(s): 86256 for each titer performed, 86052 for AQP4 Titer).
6) If DPPX is positive, then titer will be performed at an additional charge (CPT code(s): 86256).
7) If the Aquaporin 4 (NMO, neuromyelitis optica) CBA is positive, then Aquaporin 4 CBA titer will be performed at an additional charge (CPT code(s): 86052).
Preferred Specimen
Minimum Volume
Transport Container
Transport Temperature
Specimen Stability
Refrigerated: 48 hours
Frozen: 21 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Methodology
See individual assays
FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Setup Schedule
Reference Range
Clinical Significance