Aquaporin-4 (AQP4) Antibody (NMO-IgG), ELISA

Test Code

Test Details

Test code: 193
Type of disorder: Multiple Sclerosis
Disease(s) tested for: Neuromyelitis Optica
Profiles that contain this test:

Technical Information

Clinical Significance: Confirm suspected cases of NMO and assist in making a differential diagnosis and identifying the cause of MS-like symptoms in the patient. An accurate diagnosis will further help predict disease course and provide direction in treatment options.

Typical Presentation: Optic neuritis, and transverse myelitis with tetraplegia or paraplegia, sensory impairments and bladder-bowel dysfunction.

Indications for testing: Rule out NMO in patients with optic neuritis and transverse myelitis and distinguishing this disease from multiple sclerosis.
Methodology: ELISA
Reference Range: <3.0 U/ml

CPT Coding

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.

CPT: 86051

Specimen Requirements

Please label each specimen tube with two forms of patient identification. These forms of identification must also appear on the requisition form.

Specimen Type: Serum
Specimen Stability: Room temperature: 72 hours, Refrigerated: 40 days, Frozen: 5 months
Specimen Requirements: 2 mL (0.5 mL minimum) serum in a Red-top tube or Serum Separator Tube (SST)
Instructions: Serum must be separated from whole blood within 48 hours of collection.

Shipping Considerations

Transport Temperature: Refrigerated
Set-up/Analytic Time: 5-7 days

Additional Resources

Letters of Medical Necessity

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