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Encephalitis Antibody Evaluation with Reflex to Titer and Line Blot, CSF
Test Code94958
CPT Codes
86255 (x19), 86341, 83519, 86052<br><strong>This test is not available for New York patient testing.</strong>
Includes
Initial panel consits of: Encephalitis Ab Screen Tissue IFA, AMPAR1, AMPAR2, Aquaporin 4, DPPX, GABAbR, NMDAR1, CASPAR2, LGI1, and VGKC.
1) A line blot consisting of 10 analytes will be performed at an additional charge (CPT code(s): 84182 x9, 86341) as a reflex for tissue mosaic IFA suggesting one or more of the analytes on the line blot: ANNA1 (Hu), ANNA2 (Ri), PCA1 (Yo), Ma2/Ta, CV2 (CRMP5), Amphiphysin, AGNA1 (SOX1), GAD65, DNER, and Zic4. If the tissue mosaic pattern suggests ANNA3, then titer will be performed at an additional charge (CPT code(s): 86256).
2) If the tissue mosaic pattern suggests PCA-2, then titer will be performed at an additional charge (CPT code(s): 86256).
3) If the tissue mosaic IFA suggests PCA-Tr (DNER) and Western Blot shows DNER negative and Yo negative, then cell based assay IFA for DNER will be performed at an additional charge (CPT code(s): 86255).
a. If DNER CBA is positive, then titer will be performed at an additional charge (CPT code(s): 86256).
4) If the tissue mosaic IFA suggests myelin antibody, then
a. Myelin antibody IFA titer will be performed at an additional charge (CPT code(s): 86256).
b. Myelin Associated Glycoprotein (MAG) Antibody Western Blot (CPT code(s): 84182), in turn reflexing to MAG-SGPG and MAG ELISA for quantitation, will be performed at an additional charge (CPT code(s): 83520 x2).
5) If the Mosaic CBA is positive for any given analyte (NMDAR1, AMPAR1, AMPAR2, GABA-B Receptor, LGI-1, CASPR2), and the individual CBAs DPPX and Aquaporin 4 antibody, then that analyte will be titered at an additional charge (CPT code(s): 86256 for each titer performed, 86052 for AQP4 Titer).
6) If DPPX is positive, then titer will be performed at an additional charge (CPT code(s): 86256).
7) If the Aquaporin 4 (NMO, neuromyelitis optica) CBA is positive, then Aquaporin 4 CBA titer will be performed at an additional charge (CPT code(s): 86052).
1) A line blot consisting of 10 analytes will be performed at an additional charge (CPT code(s): 84182 x9, 86341) as a reflex for tissue mosaic IFA suggesting one or more of the analytes on the line blot: ANNA1 (Hu), ANNA2 (Ri), PCA1 (Yo), Ma2/Ta, CV2 (CRMP5), Amphiphysin, AGNA1 (SOX1), GAD65, DNER, and Zic4. If the tissue mosaic pattern suggests ANNA3, then titer will be performed at an additional charge (CPT code(s): 86256).
2) If the tissue mosaic pattern suggests PCA-2, then titer will be performed at an additional charge (CPT code(s): 86256).
3) If the tissue mosaic IFA suggests PCA-Tr (DNER) and Western Blot shows DNER negative and Yo negative, then cell based assay IFA for DNER will be performed at an additional charge (CPT code(s): 86255).
a. If DNER CBA is positive, then titer will be performed at an additional charge (CPT code(s): 86256).
4) If the tissue mosaic IFA suggests myelin antibody, then
a. Myelin antibody IFA titer will be performed at an additional charge (CPT code(s): 86256).
b. Myelin Associated Glycoprotein (MAG) Antibody Western Blot (CPT code(s): 84182), in turn reflexing to MAG-SGPG and MAG ELISA for quantitation, will be performed at an additional charge (CPT code(s): 83520 x2).
5) If the Mosaic CBA is positive for any given analyte (NMDAR1, AMPAR1, AMPAR2, GABA-B Receptor, LGI-1, CASPR2), and the individual CBAs DPPX and Aquaporin 4 antibody, then that analyte will be titered at an additional charge (CPT code(s): 86256 for each titer performed, 86052 for AQP4 Titer).
6) If DPPX is positive, then titer will be performed at an additional charge (CPT code(s): 86256).
7) If the Aquaporin 4 (NMO, neuromyelitis optica) CBA is positive, then Aquaporin 4 CBA titer will be performed at an additional charge (CPT code(s): 86052).
Preferred Specimen
6 mL CSF collected in a sterile leak-proof container
Minimum Volume
3.5 mL
Transport Temperature
Refrigerated (cold packs)
Specimen Stability
Room temperature: 24 hours
Refrigerated: 7 days
Frozen: 21 days
Refrigerated: 7 days
Frozen: 21 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Received room temperature
Methodology
See individual assays
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
Setup: Tues; Report available: 1 -14 days
Clinical Significance
The Encephalitis Antibody Panel provides an evaluation of possible autoantibodies in patients with suspected autoimmune encephalitis, and optimizes the likelihood of detecting neuronal specific autoantibodies, whether present singly or occurring as multiple autoantibodies.
