Encephalitis Antibody Evaluation with Reflex to Titer and Line Blot

Last Modified: 9/20/2022 10:19:22 AM

Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:  
Specimen Requirements: 6.0 mL Frozen Serum from a Red Top Tube(s) in a Plastic Vial
Collection Instructions:  
Minimum Volume: 3.5 mL Serum
Transport & Storage: Temperature/Stability: 24 hours Ambient
48 hours Refrigerated
21 days Frozen (transport)
Rejection Criteria: Gross hemolysis • Grossly lipemic • Grossly icteric • Turbid • Bacterial contamination • Received room temperature • Received refrigerated
Reference Range: Refer to Interpretive Results
Critical Ranges:  
Test Comments:  
Methodology: Multiple - Based on Individual Components
Clinical Significance:  
Custom Panel: No


Turn Around Time: 2 - 15 days
Days Performed: Tuesday
Sites Performed: Quest - Chantilly to San Juan Capistrano
PHL Test Code: ENCEP
EPIC Test Code: IMO5540
Send Out Test Code: 94955
Alternate Test Names: Autoimmune Encephalitis Panel; Encephalopathy-Autoimmune Evaluation
Included Tests: Islet Cell Antibody; Islet Cell Antibody Ab Line Blot; Protien WB
CPT Coding: 86255 x 19; 86052; 86341; 83519 x2; 86596 x 2

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