Pediatric Autoimmune Encephalitis Evaluation with Reflexes, Serum

Test Code

18410

CPT Codes
86052, 84182, 86362, 86341, 86255

Includes

Aquaporin-4 (AQP4) Antibody, CBA with Reflex to Titer, Serum
Collapsin Response-Mediator Protein-5(CRMP5/CV2) Antibody, Line Blot
Glutamic Acid Decarboxylase (GAD65) Antibody, Line Blot
MOG Antibody, CBA with Reflex to Titer, Serum
NMDAR1 Antibody, CBA with Reflex to Titer, Serum

If Aquaporin-4 (AQP4) Antibody, CBA is Positive, then Aquaporin-4 (AQP4) Antibody, Titer will be performed at an additional charge (CPT Code(s): 86052).

If MOG Antibody, CBA is Positive, then MOG Antibody, Titer will be performed at an additional charge (CPT Code(s): 86362).

If NMDAR1 Antibody, CBA is Positive, then NMDAR1 Antibody, Titer will be performed at an additional charge (CPT Code(s): 86256).

Preferred Specimen

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

Minimum Volume

1.2 mL

Transport Temperature

Room temperature

Specimen Stability

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

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

Serum separator tube (SST)

Methodology
Cell-based Immunofluorescence Assay • Line Blot

Setup Schedule

Set up: Tue, Thur, Sat; Report available: 4-6 days

Clinical Significance

Causes of autoimmune encephalitis differ between adults and children, largely due to the fact that autoimmune encephalitis in adults is more likely to be due to cancer, but in children more likely to have been caused by a viral infection. This panel will assess the most common causes of autoimmune encephalitis/encephalomyelitis in the pediatric age group.

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.