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Test Name

Encephalitis Antibody Evaluation with Reflex to Titer and Line Blot, Serum

To view specimen requirements and codes please Select a regional laboratory.

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CPT Code(s)**

86255 (x20), 86341, 83519 (x4)
**IMPORTANT: CPT Code is informational only; obtain the Test Code for ordering.

Includes

1) A line blot consisting of 10 analytes will be performed at an additional charge (CPT codes(s): 84182 x10) 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).

Reference Range(s)

See Laboratory Report

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.

Alternative Name(s)

Autoimmune Encephalitis Panel,Encephalopathy-Autoimmune Evaluation

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 guidelines 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.

* The tests listed by specialist are a select group of tests offered. For a complete list of Quest Diagnostics tests, please refer to our Directory of Services.

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Encephalitis Antibody Evaluation with Reflex to Titer and Line Blot, Serum
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