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Autoimmune Neurology Antibody Comprehensive Panel with Reflexes, Serum
Test Code93888
CPT Codes
86255 (x20), 86341 (x2), 84182 (x11), 83519 (x3), 86596 (x2)
Includes
Initial panel consits of: Neurology Ab Screen Tissue IFA, AMPAR1, AMPAR2, DPPX, GABAbR, NMDAR1, CASPAR2, LGI1, ANNA1 (Hu), ANNA2 (RI), PCA1 (YO), MA/TA, CRMP5 (CV2), Amphiphysin, GAD65, Recoverin, AGNA (SOX1), Titin, Zic4, PCA TR (DNER) and AChr Binding Antibody, Ganglionic AChR, Anti-Striated Muscle Antibody Screen, VGCC N-Type, VGCC P/Q-Type, and VGKC.
If Autoimmune Neurology Antibody Comprehensive Panel suggests NMO-5 IgG, then Aquaporin-4 Antibody will be performed at an additional charge (CPT code(s): 86052).
If Aquaporin-4 Ab is positive, then titer will be performed at an additional charge (CPT code(s): 86052).
If Autoimmune Neurology Antibody Comprehensive Panel suggests ANNA-3, then titer will be performed at an additional charge (CPT code(s): 86256).
If Autoimmune Neurology Antibody Comprehensive Panel suggests PCA2, then titer will be performed at an additional charge (CPT code(s): 86256).
If Autoimmune Neurology Antibody Comprehensive Panel suggests PCA-Tr and Paraneoplastic Ab, WB shows DNER negative and Yo Negative, then DNER, Ab, IFA will be performed at an additional charge (CPT code(s): 86255).
If DNER, Ab, IFA is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If Autoimmune Neurology Antibody Comprehensive Panel suggests Myelin Antibody, then Myelin Ab titer will be performed at an additional charge (CPT code(s): 86256), and Myelin Assoc. Glycoprotein (MAG) Antibody w/Reflex to MAG-SGPG & MAG, EIA will be performed at an additional charge (CPT code(s): 84182, 83520 x2).
If MAG Antibody (IgM), Western Blot is positive, then both MAG-SGPG Antibody (IgM), EIA and MAG Antibody (IgM), EIA will be performed at additional charge (CPT code(s): 83520 x2).
If NMDAR1 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If AMPAR1 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If AMPAR2 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If LGI-1 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If CASPR2 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If DPPX Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If GABA-B Receptor Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If AChR Binding is Negative, then AChR Modulating Ab will be performed at an additional charge (CPT code(s): 86043).
If AChR Binding is Positive (≥0.50), then AChR Blocking Ab will be performed at an additional charge (CPT code(s): 86042).
If AChR Binding is Equivocal (0.31-0.49), then both AChR Blocking and AChR Modulating will be performed at additional charge (CPT code(s): 86042, 86043).
If Anti-Striated Muscle Ab Screen is Positive, then Anti-Striated Muscle Ab Titer will be performed at an additional charge (CPT code(s): 86256).
If Autoimmune Neurology Antibody Comprehensive Panel suggests NMO-5 IgG, then Aquaporin-4 Antibody will be performed at an additional charge (CPT code(s): 86052).
If Aquaporin-4 Ab is positive, then titer will be performed at an additional charge (CPT code(s): 86052).
If Autoimmune Neurology Antibody Comprehensive Panel suggests ANNA-3, then titer will be performed at an additional charge (CPT code(s): 86256).
If Autoimmune Neurology Antibody Comprehensive Panel suggests PCA2, then titer will be performed at an additional charge (CPT code(s): 86256).
If Autoimmune Neurology Antibody Comprehensive Panel suggests PCA-Tr and Paraneoplastic Ab, WB shows DNER negative and Yo Negative, then DNER, Ab, IFA will be performed at an additional charge (CPT code(s): 86255).
If DNER, Ab, IFA is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If Autoimmune Neurology Antibody Comprehensive Panel suggests Myelin Antibody, then Myelin Ab titer will be performed at an additional charge (CPT code(s): 86256), and Myelin Assoc. Glycoprotein (MAG) Antibody w/Reflex to MAG-SGPG & MAG, EIA will be performed at an additional charge (CPT code(s): 84182, 83520 x2).
If MAG Antibody (IgM), Western Blot is positive, then both MAG-SGPG Antibody (IgM), EIA and MAG Antibody (IgM), EIA will be performed at additional charge (CPT code(s): 83520 x2).
If NMDAR1 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If AMPAR1 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If AMPAR2 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If LGI-1 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If CASPR2 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If DPPX Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If GABA-B Receptor Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).
If AChR Binding is Negative, then AChR Modulating Ab will be performed at an additional charge (CPT code(s): 86043).
If AChR Binding is Positive (≥0.50), then AChR Blocking Ab will be performed at an additional charge (CPT code(s): 86042).
If AChR Binding is Equivocal (0.31-0.49), then both AChR Blocking and AChR Modulating will be performed at additional charge (CPT code(s): 86042, 86043).
If Anti-Striated Muscle Ab Screen is Positive, then Anti-Striated Muscle Ab Titer will be performed at an additional charge (CPT code(s): 86256).
Preferred Specimen
10 mL serum collected in a red-top tube (no gel)
Minimum Volume
5 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?)
Serum Separator Tube (SST®) • 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
See individual assays
Clinical Significance
A comprehensive approach to detection of known antineuronal autoantibodies aids the diagnosis of paraneoplastic syndromes and autoimmune encephalopathies and related conditions. Identification of specific antineuronal autoantibodies may direct evaluation for idiopathic autoimmune disease or 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 line blot analysis.
