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Paraneoplastic Antibody Evaluation with Reflex to Titer and Line Blot, Basic
Test Code93876
CPT Codes
86255 (x10), 83519 (x3), 86596 (x2)
Includes
Initial panel consists of:
Paraneoplastic Antibody Screen IFA Basic
Striated Muscle Antibody with Reflex to Titer
Acetylcholine Receptor Binding Antibody
Acetylcholine Receptor Ganglionic (Alpha 3) Antibody
Voltage-Gated Calcium Channel (VGCC) Type N Antibody
Voltage-Gated Calcium Channel (VGCC) Type P/Q Antibody
Voltage-Gated Potassium Channel (VGKC) Antibody
If Paraneoplastic Antibody Screen, IFA, Basic is positive for ANNA3, then ANNA-3 Ab, IFA Titer will be performed at an additional charge (CPT code(s) 86256).
If Paraneoplastic Antibody Screen, IFA, Basic is positive for PCA-2, then PCA-2 Ab, IFA Titer will be performed at an additional charge (CPT code(s) 86256).
If Paraneoplastic Antibody Screen, IFA, Basic suggests NMO-5-IgG, then specific CBA-IFA assay will be performed at an additional charge (CPT code(s) 86255).
If Paraneoplastic Antibody Screen, IFA, Basic suggests AMPA-R, GABA-B-R, or NMDA-R, then specific CBA-IFA assay will be performed.
If Paraneoplastic Antibody Screen, IFA, Basic is positive or indeterminate, then Paraneoplastic Antibody, LB, Basic will be performed.
If Striated Muscle Antibody Screen is positive, then Striated Muscle Antibody Titer will be performed at an additional charge (CPT code(s): 86256).
If Acetylcholine Receptor Binding Antibody is positive (≥0.50) or equivocal (0.31-0.49), then Paraneoplastic Antibody, LB, Basic and Acetylcholine Receptor Modulating Antibody will both be performed at additional charges (CPT code(s) 86043).
Paraneoplastic Antibody Screen IFA Basic
Striated Muscle Antibody with Reflex to Titer
Acetylcholine Receptor Binding Antibody
Acetylcholine Receptor Ganglionic (Alpha 3) Antibody
Voltage-Gated Calcium Channel (VGCC) Type N Antibody
Voltage-Gated Calcium Channel (VGCC) Type P/Q Antibody
Voltage-Gated Potassium Channel (VGKC) Antibody
If Paraneoplastic Antibody Screen, IFA, Basic is positive for ANNA3, then ANNA-3 Ab, IFA Titer will be performed at an additional charge (CPT code(s) 86256).
If Paraneoplastic Antibody Screen, IFA, Basic is positive for PCA-2, then PCA-2 Ab, IFA Titer will be performed at an additional charge (CPT code(s) 86256).
If Paraneoplastic Antibody Screen, IFA, Basic suggests NMO-5-IgG, then specific CBA-IFA assay will be performed at an additional charge (CPT code(s) 86255).
If Paraneoplastic Antibody Screen, IFA, Basic suggests AMPA-R, GABA-B-R, or NMDA-R, then specific CBA-IFA assay will be performed.
If Paraneoplastic Antibody Screen, IFA, Basic is positive or indeterminate, then Paraneoplastic Antibody, LB, Basic will be performed.
If Striated Muscle Antibody Screen is positive, then Striated Muscle Antibody Titer will be performed at an additional charge (CPT code(s): 86256).
If Acetylcholine Receptor Binding Antibody is positive (≥0.50) or equivocal (0.31-0.49), then Paraneoplastic Antibody, LB, Basic and Acetylcholine Receptor Modulating Antibody will both be performed at additional charges (CPT code(s) 86043).
Preferred Specimen
6 mL frozen serum
Minimum Volume
3 mL
Transport Temperature
Frozen
Specimen Stability
Room temperature: 48 hours
Refrigerated: 48 hours
Frozen 21 days
Refrigerated: 48 hours
Frozen 21 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Grossly lipemic • Grossly icteric samples • Turbid • Bacterial contamination
Methodology
See individual tests
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 FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Setup Schedule
Step up: Varies; Report available: 3-12 days
Clinical Significance
Detection of antineuronal autoantibodies aids the diagnosis of paraneoplastic syndromes and autoimmune encephalopathies and related conditions. Identification of specific antineuronal autoantibodies may direct evaluation for underlying often occult malignancy. Characterization of autoantibody specificity may allow syndromic classification and assist in diagnosis and management. Antineuronal antibodies are detected and characterized based on indirect immunofluorescence staining pattern on multiple neuronal, non-neuronal tissues, and transformed substrate cells, and radioimmunoassays, and western blot analysis.
