Geisinger Medical Laboratories/Geisinger Proven Diagnostics Test Catalog

Order Display Name: Geisinger Epic Procedure Code Or ID CPT Code:  

LYME DISEASE ANTIBODY SCREEN WITH REFLEX TO WESTERN BLOT

ORDERING INFORMATION:
Geisinger Epic Procedure Code: LAB2629         Geisinger Epic ID: 37734

SPECIMEN COLLECTION
Specimen type:
Serum
Preferred collection container:
Alternate Collection Container:
6 mL red-top (plain, non-serum separator) tube
Specimen required:
0.5 mL serum; minimum 0.5 mL

SPECIMEN PROCESSING
Specimen processing instructions:
Allow to clot. Centrifuge and submit 0.5 mL serum. 
Transport temperature:
Refrigerated (preferred). Room temperature (stable 8 hours) and frozen specimens also acceptable.
Specimen stability:
Room temperature: 8 hours. 2-8°C: 7 days. Frozen: 6 months.
Rejection criteria:
Specimen stability exceeded; specimen grossly hemolyzed.

TEST DETAILS
Interpretation guide:
Lyme Screen is interpreted as follows:
Negative: No detectable antibody; result does not exclude B. burgdorferi infection. An additional sample should be tested within 2-4 weeks if early infection is suspected.

Equivocal: Current recommendations state that equivocal results should be followed by supplemental Western Blot testing.

Positive: Antibody to B. burgdorferi presumptively detected. Per current recommendation, the result cannot be further interpreted without supplemental Western Blot testing.

Lyme Western Blot is interpreted as follows:
Negative: Lyme WB IGG: Less than 5 of 10 significant bands or no bands present.
Negative: Lyme WB IGM: Less than 2 of 3 significant bands or no band present.
Additional information:
Test progresses to Lyme Western Blot at an additional charge if patient results are positive or repeatedly equivocal.Reference: 2nd National Conference on Serological Diagnosis Lyme Disease, CDC/ASTPHLD, 1994.
CPT code(s):
86618, 86617 x2 (confirmatory Lyme Western Blot if screen positive)
Note: The billing party has sole responsibility for CPT coding.  Any questions regarding coding should be directed to the payer being billed.  The CPT codes provided by GML are based on AMA guidelines and are for informational purposes only.
Test includes:
Qualitative determination of IgM/IgG antibodies by screen with reflex to Lyme Western Blot testing if screen is positive.
Methodology:
Chemiluminescence
Western Blot
Synonyms:
Borrelia Burgdorferi Antibody IgG/IgM; Lyme Screen; Lyme Progressive; Lyme Titer
LYMPRO
Clinical significance:
Lyme disease is caused by a bacterium, Borrelia burgdorferi, that is transmitted by the ticks of the genus Ixodes. A Lyme IgM test should be used for patients with signs and symptoms that are consistent with Lyme disease. Patients with early infection produce IgM antibodies during the first few weeks after onset of the classical rash (erythema migrans) and produce IgG antibodies more slowly. Both IgG and IgM antibodies can remain detectable for years. CDC recommends that equivocal or positive results be supplemented with a confirmatory Lyme Western Blot assay.
Doctoral Director(s:)
Hoi-Ying Elsie Yu, PhD, DABCC
Stacy Kenyon, PhD, DABCC
   
Review Date: 12/03/2020

Performing Locations

Geisinger Medical Center

Performing laboratory: Immunology
Technical Lead: Kathy Hurst
Frequency: Screening: Five days per week, 1st shift.
Lyme Western Blot: Two days per week, 1st shift.
Performed stat? No
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