Aquaporin-4 (AQP4) (NMO-IgG) Antibody, CBA with Reflex to Titer

Test Code

38370

CPT Codes
86052<br>Restricted Client Code

Physician Attestation of Informed Consent

This germline genetic test requires physician attestation that patient consent has been received if ordering medical facility is located in AK, DE, FL, GA, IA, MA, MN, NV, NJ, NY, OR, SD or VT or test is performed in MA.

Includes

If the Aquaporin 4 Antibody, Serum is positive, then Aquaporin 4 Antibody, Titer, Serum will be performed at an additional charge (CPT code(s): 86052).

Preferred Specimen

2 mL serum

Minimum Volume

0.5 mL

Other Acceptable Specimens

2 mL CSF collected in a plastic screw-cap vial

Instructions

Please label each specimen tube with two forms of patient identification. These forms of identification must also appear on the requisition form. Serum must be separated from whole blood within 48 hours of collection.

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: 72 hours
Refrigerated: 30 days
Frozen: 30 days

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

Turbid • Any suggestion of bacterial contamination

Methodology
Cell-based Immunofluorescence Assay

Setup Schedule

Set up: As needed; Report available: 3-7 days

Report Available

Reports in 4 to 9 days.

Clinical Significance

NMO (neuromyelitis optica, Devic disease) is an immune- mediated chronic inflammatory disease that predominantly affects the optic nerve and spinal cord and presents with optic neuritis (ON) and myelitis. Limited forms of this disease, such as isolated ON, brainstem encephalitis and longitudinal extensive transverses myelitis (LETM), have been referred to as NMO spectrum disorders (NMOSD). NMO was originally thought to be a variant of multiple sclerosis, but is now recognized as a distinct disease. The presence of serum antibodies against aquaporin-4 (AQP4) is associated with NMO and NMOSD.

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.