Myocarditis/Pericarditis Panel

Test Code
12670


CPT Codes
86632, 86631 (x2), 86658 (x5), 86710 (x2)

Includes
Echovirus Antibody Panel
⁠⁠⁠⁠⁠⁠⁠Influenza A and B Antibodies, Serum
Chlamydophila pneumoniae Antibodies (IgG, IgA, IgM)


Preferred Specimen
2 mL serum


Minimum Volume
1 mL


Transport Container
Transport tube


Transport Temperature
Room temperature


Specimen Stability
Room temperature: 7 days
Refrigerated: 14 days
Frozen: 30 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Grossly lipemic • Grossly icteric


Methodology
Complement Fixation (CF) • Immunofluorescence Assay (IFA)

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
Set up and Report available: See individual assays


Reference Range
Echovirus Antibody Panel
Echovirus 4 Ab<1:8 titer
Echovirus 7 Ab<1:8 titer
Echovirus 9 Ab<1:8 titer
Echovirus 11 Ab<1:8 titer
Echovirus 30 Ab<1:8 titer

Influenza A and B Antibodies, Serum
Influenza Type A Ab<1:8 titer
Influenza Type B Ab<1:8 titer

Chlamydophila pneumoniae Antibodies (IgG, IgA, IgM)
C. pneumoniae (IgG)<1:64
C. pneumoniae (IgA)<1:16
C. pneumoniae (IgM)<1:10


Clinical Significance
Clinical use is for investigation of causes of myocarditis and pericarditis (includes Influenza A Virus Ab, Influenza B Virus Ab, Echovirus Ab, and Chlamydophila pneumoniae Ab).




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.