Lyme Disease Antibodies (Acute Disease)
| Label Mnemonic: | LYMEA |
| Epic code: | LAB7769 |
| Order form: | Laboratory Requisition |
| Supply order: | Supply Order Form |
| Billing: | Billing Policies |
| CPT code: | 86618 Lyme IgG/IgM; if positive add, 86617 x2 Lyme IgG/IgM |
Specimen(s):
Serum
Collection Medium:
 |
| Red top tube 5 mL (Clot Activator) |
Minimum:
3 mL whole blood from red top tube or TWO red top Microtainer® devices for pediatric patients.
Testing
Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around
Time:
2 hours (upon receipt in laboratory)
Reference Range:
Borrelia burgdorferi IgM & IgG Antibodies <=0.8 AI: Negative 0.9 – 1.0 AI: Equivocal >=1.1 AI: Positive Lyme Ab IgG Confirmation Negative Lyme Ab IgM Confirmation Negative
Comments:
This panel is appropriate for Lyme disease testing less than four
weeks from erythema migrans or onset of disease symptoms.
If initial screen is equivocal or positive, then IgG and IgM Immunoblot will be added. Additional charges apply.
Current CDC recommendations for the serological diagnosis of Lyme disease are to screen with a polyvalent ELISA test and confirm equivocals and positives with Western blot. Both IgM and IgG Western blots should be performed on specimens obtained less than four weeks after appearance of erythema migrans or disease symptoms. Only IgG Western blot is to be performed on specimens greater than four weeks after disease onset. IgM Western blot in the chronic stage is not recommended and does not aid in the diagnosis of neuroborreliosis or chronic Lyme disease.
If initial screen is equivocal or positive, then IgG and IgM Immunoblot will be added. Additional charges apply.
Current CDC recommendations for the serological diagnosis of Lyme disease are to screen with a polyvalent ELISA test and confirm equivocals and positives with Western blot. Both IgM and IgG Western blots should be performed on specimens obtained less than four weeks after appearance of erythema migrans or disease symptoms. Only IgG Western blot is to be performed on specimens greater than four weeks after disease onset. IgM Western blot in the chronic stage is not recommended and does not aid in the diagnosis of neuroborreliosis or chronic Lyme disease.
Methodology:
Multiplex Flow Immunoassay/Qualitative Western Blot
Sample
Processing:
Allow to clot completely at room temperature. Separate serum from cells ASAP.
Centrifuge at a speed and time necessary to get barrier separation of plasma/serum and cells.
Separate plasma or serum into labeled container and cap.
Label transport tube with two patient identifiers, date and time of collection.
Centrifuge at a speed and time necessary to get barrier separation of plasma/serum and cells.
Separate plasma or serum into labeled container and cap.
Label transport tube with two patient identifiers, date and time of collection.
Sample
Storage:
Refrigerate.
Transport
Instructions:
Place labeled specimen into zip-lock type biohazard bag; seal bag.
Place completed requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
Place completed requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
CPT Code:
86618 Lyme IgG/IgM; if positive add, 86617 x2 Lyme IgG/IgM