Lyme Disease Antibody Total, reflex to Confirmation

Test Code

LYMAB

Alias/See Also

Epic: LAB2660

Borrelia burgdorferi
B. burgdorferi

Includes

If Lyme disease serology is positive, then Lyme disease antibody confirmation will be performed at an additional charge.

Preferred Specimen

Specimen Type: Serum
Collection Container: Serum gel
Specimen Volume: 3 mL

Minimum Volume

0.5 mL

Other Acceptable Specimens

Collection Container: Red top

Instructions

Centrifuge and separate cells after clot formation and within 4 hours of collection.

Transport Container

Plastic vial

Specimen Stability

Room temperature: Unacceptable
Refrigerated: 7 days
Frozen: >7 days

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

Unlabeled, mislabeled, wrong tube type, QNS, severely hemolyzed samples and any sample from which the lipid layer has not been removed.

Methodology

Chemiluminescent Immunoassay (CLIA)

Setup Schedule

Monday - Friday

Report Available

1 day

Reference Range

Negative

Clinical Significance

Lyme disease is caused by the tickborne spirochete Borrelia burgdorferi and is the most common vector-borne disease in the United States. The CDC initiated surveillance for Lyme disease in 1982, and since 1991 Lyme disease has been a nationally reportable disease. In the United States, the disease is primarily localized to states in the northeast, mid-Atlantic, upper north-central regions and northwestern California. The bacterium, Borrelia burgdorferi is the etiologic agent of Lyme borreliosis, a disease which is transmitted by different tick species of the genus Ixodes. Lyme borreliosis is a multisystemic disorder that can affect several organs, such as skin, nervous system, large joints and cardiovascular system. Even though Lyme disease spirochetes elicit a vigorous immune response, Borrelia bacteria survive and persist in the circulation of infected patients. Similar to syphilis, Lyme borreliosis generally progresses through several different stages, from early to late infection:

Stage 1 – Localized infection: After an incubation period a slowly expanding skin lesion, erythema migrans (EM), forms at the site of the tick bite in 70-80% of the cases. General flu-like symptoms including malaise, fatigue, headache, arthralgias, myalgias and fever accompany the skin lesion.
Stage 2 – Disseminated infection: B. burgdorferi often disseminates within days to weeks after disease onset. Possible clinical manifestations include secondary skin lesions, acute lymphocytic meningitis and musculoskeletal pain in joints, tendon, muscle or bone.
Stage 3 – Persistent infection: After weeks of disseminated infection, the Lyme disease agents may still survive in localized niches and may persist up to several years. Months after onset of illness, about 60% of untreated patients with this infection experience intermittent attacks of arthritis.
Differential diagnosis of Lyme disease is difficult as clinical manifestations associated with different stages of the disease are variable. Diagnosis of Lyme disease is based upon a physician's review of clinical symptoms, patient's exposure to an endemic area, and laboratory test results. In ambiguous cases, there may be a greater reliance on laboratory data to confirm the diagnosis.

Performing Laboratory

Inova Laboratories

2832 Juniper Street

Fairfax, VA 22031

Additional Information
Lyme IgG and IgM

Last Updated: September 27, 2023
Last Review: N. Wolford, April 11, 2023

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.