Encephalitis Antibody Evaluation with Reflex to Titer and Line Blot

Last Modified: 9/23/2021 7:35:20 AM


Specimen Requirements: 6.0 mL Frozen Serum from a Red Top Tube(s) in a Plastic Vial
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
Methodology: Multiple - Based on Individual Components
Documentation: 1) A line blot consisting of 10 analytes will be performed at an additional charge (CPT codes(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 codes(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, 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 per titer).

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).
Custom Panel: No

PRODUCTION SCHEDULE

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: 86341, 83519, 84182, 86341, Reflex 83520 up to 2x, 83526 up to 12x, 86255

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