Paraneoplastic Autoantibody Evaluation, CSF

Test Code

94210

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

Includes

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

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

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

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

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

If IFA patterns suggest collapsin response-mediator protein (CRMP)-5-IgG, then CRMP-5-IgG Western blot 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 patterns suggest neuronal voltage-gated potassium channel-complex (VGKC) autoantibody, then VGKC-complex antibody RIA is performed at an additional charge (CPT code(s): 83519)

If VGKC-complex antibody RIA result is greater than 0.00 nmol/L, then leucine-rich, glioma inactivated 1 (LGI1)-IgG cell-binding assay (CBA) and contactin-associated protein-like 2 (CASPR2)-IgG CBA are performed at an additional charge (CPT code(s): 86255(x2))

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

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

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

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

Preferred Specimen

4 mL CSF collected in a sterile vial

Minimum Volume

2 mL

Instructions

Additional Information: Include relevant clinical information, name, phone number, mailing address, and e-mail address (if applicable) of ordering physician.

Forms: If not ordering electronically, submit a Neurology Specialty Testing Client Test Request Form (Supply T732) with the specimen.

Please note: In patients with a history of tobacco use or other lung cancer risk. or if thymoma is suspected, PAVAL/Paraneoplastic Autoantibody Evaluation, Serum is also recommended.

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
Western Blot • Cell-binding Assay (CBA) • Indirect Immunofluorescence Assay • Immunoblot • Radioimmunoassay

FDA Status
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

Setup Schedule

Set up: Daily; Report available: 5-10 days

Reference Range

See Laboratory Report

Clinical Significance

Aids in the diagnosis of paraneoplastic neurological autoimmune disorders related to carcinoma of lung, breast, ovary, thymoma, or hodgkin lymphoma in spinal fluid specimens

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.