| Test code: | 1523 |
| Type of disorder: | Multiple Sclerosis |
| Disease(s) tested for: | Neuromyelitis Optica, Myelin Disorder, Demyelinating Disease |
| Profiles that contain this test: | NMO Spectrum Evaluation (AQP4, CBA reflex to MOG, CBA) NMO Spectrum Evaluation (AQP4, ELISA reflex to MOG, CBA) |
| Special Notes: | If the MOG Antibody, CBA is positive a semi-quantitative titer will be performed at an additional charge (CPT code 86362). |
| Clinical Significance: | Neuromyelitis optica (NMO) is an inflammatory disorder predominantly affecting the optic nerves and spinal cord. Limited forms of disease including isolated optic neuritis, brainstem encephalitis and longitudinal extensive transverse myelitis (LETM) or acute disseminated encephalomyelitis (ADEM) have been referred to as NMO spectrum disorder (NMOSD). The majority of individuals with NMO and many with NMOSD have antibodies against aquaporin-4 (AQP4). MOG antibodies have been reported without AQP4 antibodies in individuals with NMO and other non-multiple sclerosis demyelinating diseases. The presence of MOG antibodies in AQP4 antibody negative individuals can help differentiate between multiple sclerosis (MS) and non-MS demyelinating diseases and aid in clinical management decisions. |
| Methodology: | Cell-based Immunofluorescence Assay |
| Reference Range: | See 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.
| CPT: | 86362 |
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: 45 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. |
| Alternate Specimen Type: | Cerebrospinal Fluid (CSF) |
| Alternate Specimen Stability: | Room temperature: 72 hours, Refrigerated: 45 days, Frozen: 39 days, |
| Alternate Specimen Requirements: | 2 mL (0.5 mL minimum) CSF collected in a plastic screw cap vial |
| Transport Temperature: | Refrigerated |
| Reject Criteria | Turbid and/or any suggestion of bacterial contamination |
| Set-up/Analytic Time: | 3-7 days |
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