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Encephalitis Antibody Evaluation with Reflex to Titer and Line Blot, CSF
Test Code94958
CPT Codes
86255 (x19), 86052, 86341, 83519
Includes
If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with one or more antibodies including AGNA1 (SOX1), Amphiphysin, ANNA1 (Hu), ANNA2 (Ri), CRMP5(CV2), GAD65, Ma2/Ta, PCA1 (Yo), PCA Tr (DNER), and Zic4, then a line blot consisting of these 10 antibodies will be performed.
If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with ANNA3, then titer will be performed.
If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with PCA2, then titer will be performed.
If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with PCA Tr (DNER) and Neurology Antibody Line Blot shows PCA Tr (DNER) Negative and PCA1 (Yo) Negative, then PCA Tr (DNER) Ab, CBA, CSF will be performed at an additional charge (CPT code(s): 86255).
If PCA Tr (DNER) Ab, CBA, CSF is Positive, then titer will be performed.
If Encephalitis Antibody Screen, Tissue IFA for Myelin suggests a fluorescence pattern consistent with Myelin Antibody, then titer will be performed at an additional charge (CPT code(s): 86256).
If Neurology Antibody, CBA is Positive for NMDAR1, AMPAR2, LGI1, or CASPR2, then titers will be performed at an additional charge (CPT code(s): 86256 for each titer performed).
If Aquaporin 4 (AQP4) Ab, CBA is Positive, then titer will be performed at an additional charge (CPT code (s): 86052).
If Neurology Antibody, CBA is Positive for AMPAR1 or GABABR, then titers will be performed.
If DPPX Antibody, CBA is Positive, then titer will be performed.
If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with ANNA3, then titer will be performed.
If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with PCA2, then titer will be performed.
If Encephalitis Antibody Screen, Tissue IFA suggests a fluorescence pattern consistent with PCA Tr (DNER) and Neurology Antibody Line Blot shows PCA Tr (DNER) Negative and PCA1 (Yo) Negative, then PCA Tr (DNER) Ab, CBA, CSF will be performed at an additional charge (CPT code(s): 86255).
If PCA Tr (DNER) Ab, CBA, CSF is Positive, then titer will be performed.
If Encephalitis Antibody Screen, Tissue IFA for Myelin suggests a fluorescence pattern consistent with Myelin Antibody, then titer will be performed at an additional charge (CPT code(s): 86256).
If Neurology Antibody, CBA is Positive for NMDAR1, AMPAR2, LGI1, or CASPR2, then titers will be performed at an additional charge (CPT code(s): 86256 for each titer performed).
If Aquaporin 4 (AQP4) Ab, CBA is Positive, then titer will be performed at an additional charge (CPT code (s): 86052).
If Neurology Antibody, CBA is Positive for AMPAR1 or GABABR, then titers will be performed.
If DPPX Antibody, CBA is Positive, then titer will be performed.
Preferred Specimen
4 mL CSF collected in a sterile leak-proof container
Minimum Volume
2 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
Setup Schedule
Setup: Tues; Report available: 1 -14 days
Clinical Significance
Encephalitis due to anti-neuronal autoantibodies may present in a variety of ways and may be associated with a variety of tumors. Screening for anti-neuronal autoantibodies is performed using tissue immunofluorescence with confirmation by line blot assay. This CSF panel also includes additional testing for autoantibodies frequently associated with encephalitis such as NMDA receptor using cell-based assays. Testing using both serum and CSF increases sensitivity for detection.
