NMO Spectrum Evaluation (AQP4 with Reflex to MOG), Serum

Test Code

38312

CPT Codes
86052

Includes

If the Aquaporin 4 Antibody, Serum is positive, then AQP4 Antibody, Titer, Serum will be performed at an additional charge (CPT code: 86052).
If the Aquaporin 4 Antibody, Serum is negative, then MOG Antibody, CBA, Serum will be performed at an additional charge (CPT code: 86362.
If the MOG Antibody, CBA, Serum is positive, then MOG Antibody, Titer, Serum will be performed at an additional charge (CPT code: 86362).

Preferred Specimen

2 mL serum collected in a red-top tube (no gel)

Minimum Volume

1 mL

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

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

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

Serum separator tube • Gross hemolysis • Grossly lipemic

Methodology
Cell-based Immunofluorescence Assay

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

Thursday, Sunday Morning
Report available: 8 Days

Reference Range

Aquaporin 4 Ab, CBA, Serum	Negative
Aquaporin 4 Ab, Titer, Serum	<1:10 Titer
MOG Ab, CBA, Serum	Negative
MOG Ab, Titer, Serum	<1:10 Titer

Clinical Significance

NMO (neuromyelitis optica, Devic disease) is an immune- mediated chronic inflammatory disease that predominantly affects the optic nerve and spinal cord and presents with optic neuritis (ON) and myelitis. Limited forms of this disease, such as isolated ON, brainstem encephalitis and longitudinal extensive transverses myelitis (LETM), have been referred to as NMO spectrum disorders (NMOSD). NMO was originally thought to be a variant of multiple sclerosis but is now recognized as a distinct disease. The presence of serum antibodies against aquaporin-4 (AQP4) or myelin oligodendrocyte glycoprotein (MOG-IgG) is associated with NMO and NMOSD.

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.