Paraneoplastic Antibody Expanded Evaluation with Reflex to Titer and LB, CSF
Test code
CPT code(s)*
Clinical significance
Details
Includes
Initial panel consists of: Neurology Ab Screen Tissue IFA, AMPAR1, AMPAR2, Aquaporin4, DPPX, GABABR, NMDAR1, CASPR2, LGI1, and VGKC.
If Paraneoplastic Expanded Ab Screen, Tissue IFA suggests one or more positive analytes, a line blot consisting of 10 analytes will be performed: ANNA1 (Hu), ANNA2 (Ri), PCA1 (Yo), Ma2/Ta, CRMP5(CV2), Amphiphysin, AGNA (SOX1), GAD65, PCA Tr (DNER), and Zic4.
If the Paraneoplastic Expanded Ab Screen, Tissue IFA suggests ANNA3, then titer will be performed (CPT code 86256).
If the Paraneoplastic Expanded Ab Screen, Tissue IFA suggests PCA-2, then titer will be performed (CPT code 86256).
If the Paraneoplastic Expanded Ab Screen, Tissue IFA suggests PCA-Tr (DNER) and Neurology Antibody Line Blot shows PCA Tr (DNER) negative and PCA1 (Yo) negative, then Purkinje Cell Cytoplasmic Antibody Type Tr (DNER), CBA, IFA will be performed at an additional charge (CPT code(s): 86255).
If Purkinje Cell Cytoplasmic Antibody Type Tr (DNER), CBA is positive, then titer will be performed.
If the Paraneoplastic Expanded Ab Screen, Tissue IFA for Myelin suggests myelin antibody, then Myelin antibody IFA titer will be performed at an additional charge (CPT code(s): 86256).
If the Neurology Antibody, CBA is positive for NMDAR1, AMPAR2, LGI-1, or CASPR2, then those analytes will be titered at an additional charge (CPT code(s): 86256 for each titer performed, 86052 for AQP4 Titer).
If the Aquaporin 4(AQP4)Ab, CBA is positive, then titer will be performed at an additional charge (CPT code(s): 86052).
If the Neurology Antibody, CBA is positive for AMPAR1 or GABA-B Receptor, then titers will be performed.
If the DPPX Receptor Antibody, CBA is positive, then titer will be performed.
Methodology
See individual tests
Assay category
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Alternative name(s)
Para Expanded CSF,Autoimmune Paraneoplastic Panel Reflex,PNS Expanded
Specimen requirements | |
|---|---|
| Patient preparation | None Specified |
| Preferred specimen(s) | 4 mL CSF collected in a sterile leak-proof container |
| Minimum volume | 2 mL |
| Transport container | Sterile leak-proof container |
| Transport temperature | Refrigerated (cold packs) |
| Specimen stability | Room temperature: 24 hours Refrigerated: 7 days Frozen: 21 days |
| Reject criteria | Received room temperature |
Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.
*The CPT codes provided are based on AMA guidance and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
This material contains content from LOINC® (http://loinc.org). The LOINC Table, LOINC Table Core are copyright © 1995-2019, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license.
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