Geisinger Medical Laboratories/Geisinger Proven Diagnostics Test Catalog

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

ENCEPHALITIS ANTIBODY EVALUATION WITH REFLEX TO TITER AND LINE BLOT, CSF

ORDERING INFORMATION:
Geisinger Epic Procedure Code: LAB1169         Geisinger Epic ID: 52601

SPECIMEN COLLECTION
Specimen type:
CSF
Preferred collection container:
Specimen required:
6 mL CSF; minimum 3.5 mL

SPECIMEN PROCESSING
Transport temperature:
Refrigerated (cold packs).
Specimen stability:
Room temperature: 24 hours. Refrigerated: 7 days. Frozen: 21 days.
Rejection criteria:
Received room temperature.

TEST DETAILS
CPT code(s):
86255 (x20), 86341, 83519
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:
  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, titer will be performed at an additional charge (CPT code(s): 86256).
  2. If the tissue mosaic pattern suggests PCA-2, 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, 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).
  6. If DPPX is positive, 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): 86256).
Methodology:
See individual member listings.
Synonyms:
Quest test code 94958, Enceph Rflx
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.

Performing Locations

Quest Diagnostics

Technical Lead: Michael Weaver    
Frequency: Set up: Tues; Report available: 2-15 days    
Performed stat? No
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