Paraneoplastic Autoantibody Evaluation, Serum

Test Code

94132

CPT Codes
⁠⁠⁠⁠⁠⁠⁠83519, 86255 (x9), 86596<br>Restricted Client Code

Includes

If immunofluorescence assay (IFA) patterns suggest antiglial nuclear antibody-1 (AGNA-1) antibody, then AGNA-1 immunoblot is performed at an additional charge (CPT code(s): 84182)

If IFA patterns suggest amphiphysin antibody, then amphiphysin immunoblot is performed at an additional charge. (CPT code(s): 84182).

If IFA patterns suggest antineuronal nuclear antibodies (ANNA)-1 antibody, then ANNA-1 immunoblot is performed at an additional charge. (CPT code(s): 84182).

If IFA patterns suggest ANNA-2 antibody, then ANNA-2 immunoblot is performed at an additional charge. (CPT code(s): 84182).

If IFA patterns suggest Purkinje cytoplasmic antibody (PCA)-1 antibody, then PCA-1 immunoblot is performed at an additional charge. (CPT code(s): 84182).

If IFA patterns suggest PCA-Tr antibody, then PCA-Tr immunoblot is performed at an additional charge. (CPT code(s): 84182).

If IFA patterns suggest glutamic acid decarboxylase 65 (GAD65) antibody, then GAD65 antibody radioimmunoassay (RIA) is performed at an additional charge. (CPT code(s): 86341).

If IFA pattern suggests N-methyl-D-aspartate (NMDA)-receptor, then NMDA-receptor antibody cell-binding assay (CBA), and/or NMDA- receptor antibody titer is performed at an additional charge. (CPT code(s): 86255, 86256).

If IFA pattern suggests alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-receptor, then AMPA- receptor antibody CBA and/or AMPA- receptor antibody titer is performed at an additional charge. (CPT code(s): 86255, 86256).

If IFA pattern suggests gamma-aminobutyric acid B (GABA-B)-receptor, then GABA-B- receptor antibody CBA and/or GABA-B- receptor antibody titer is performed at an additional charge. (CPT code(s): 86255, 86256).

If IFA pattern suggests dipeptidyl-peptidase-like protein-6 antibody (DPPX), then DPPX antibody CBA and DPPX antibody titer is performed at an additional charge. (CPT code(s): 86255, 86256)

If IFA pattern suggests metabotropic glutamate receptor 1 (mGluR1), then mGluR1 antibody CBA and mGluR1 antibody titer is performed at an additional charge. (CPT code(s): 86255, 86256).

If voltage-gated potassium channels (VGKC) is above 0.00 nmol/L, then leucine-rich, glioma inactivated 1 (LGI1)-IgG CBA and contactin-associated protein-like 2 (CASPR2)-IgG are performed at an additional charge. (CPT code(s): 86255(x2)).

If collapsin response-mediator protein (CRMP) IFA is positive, then acetylcholine (muscle) receptor (AChR) binding antibody, CRMP-5-IgG Western blot, and ACh receptor (muscle) modulating antibody by fluorescence-activated cell sorting (FACS) will be performed at an additional charge. (CPT code(s): 84182, 86255).

CRMP-5-IgG Western blot is also performed by specific request for more sensitive detection of CRMP-5-IgG(CPT code(s): 84182).

Testing should be requested in cases of subacute basal ganglionic disorders (chorea, Parkinsonism), cranial neuropathies (especially loss of vision, taste, or smell) and myelopathies.

Preferred Specimen

4 mL Serum

Patient Preparation
1. For optimal antibody detection, specimen collection is recommended prior to initiation of immunosuppressant medication.
2. This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. The specific waiting period before specimen collection will depend on the isotope administered, the dose given and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive specimens received in the laboratory will be held 1 week and assayed if sufficiently decayed or canceled if radioactivity remains.
3. Patient should have no general anesthetic or muscle-relaxant drugs in the previous 24 hours.

Minimum Volume

2 mL

Instructions

Provide the following information:
1. Relevant clinical information
2. Ordering Provider name, phone number, mailing address, and e-mail address

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 72 hours
Refrigerated: 28 days
Frozen: 28 days

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

Gross hemolysis • Grossly lipemic • Grossly icteric

Methodology
Immunofluorescence Assay (IFA) • Radioimmunoassay (RIA) • Western Blot (WB) • Immunoblot (IB) • Cell-Binding Assay (CBA)

Setup Schedule

Set up: Daily; Report available: 10-17 days

Reference Range

See Laboratory Report

Clinical Significance

Serological evaluation of patients who present with a subacute neurological disorder of undetermined etiology, especially those with known risk factors for cancer

Directing a focused search for cancer

Investigating neurological symptoms that appear during, or after, cancer therapy and are not explainable by metastasis

Differentiating autoimmune neuropathies from neurotoxic effects of chemotherapy

Monitoring the immune response of seropositive patients during cancer therapy

Detecting early evidence of cancer recurrence in previously seropositive patients

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.