NMO Spectrum Evaluation (AQP4, ELISA reflex to MOG, CBA)

Test Code
1284

Test Details


Test code: 1284
Type of disorder: Multiple Sclerosis
Disease(s) tested for: Neuromyelitis Optica, Myelin Disorder, Demyelinating Disease
Tests included:
Special Notes: If the AQP4 Antibody, ELISA is negative the MOG Antibody, CBA will be performed at an additional charge (CPT code 86255). If the MOG Antibody, CBA is positive a semi-quantitative titer will be performed at an additional charge (CPT code 86256).

Technical Information


Clinical Significance: NMO (neuromyelitis optica, Devic disease) is an immune-mediated chronic inflammatory disease that predominantly affects the optic nerve and spinal cord and presents with optic neuritis (ON) and transverse myelitis. Limited forms of this disease, such as isolated ON, brainstem encephalitis and longitudinal extensive transverses myelitis (LETM), have been referred to as NMO spectrum disorders (NMOSD). NMO was originally thought to be a variant of multiple sclerosis but is now recognized as a distinct disease. The presence of serum antibodies against aquaporin-4 (AQP4) or myelin oligodendrocyte glycoprotein (MOG-IgG) is associated with NMO and NMOSD.
Methodology: Enzyme Linked Immunosorbent Assay, Cell-based Immunofluorescence Assay
Reference Range: See Laboratory Report

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: 83516

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

Shipping Considerations


Transport Temperature: Refrigerated
Reject Criteria: Turbid and/or any suggestion of bacterial contamination
Set-up/Analytic Time: 7-14 days

Additional Resources

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