Borrelia burgdorferi Antibodies, Total by ELISA with Reflex to IgG and IgM by Immunoblot (Early Disease)
Ordering Recommendation

Preferred reflex test to detect Lyme disease in individuals with ≤4 weeks of clinical symptoms or exposure to tick. Positive/equivocal screen confirmed by immunoblot.

Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Qualitative Immunoblot
1-3 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Serum separator tube. 
Specimen Preparation
Separate serum from cells ASAP or within 2 hours of collection. Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.15 mL) 
Storage/Transport Temperature
Unacceptable Conditions
CSF or plasma. Contaminated, heat-inactivated, hemolyzed, or severely lipemic specimens. 
After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles) 
Reference Interval
Test Number
Reference Interval
0050216Borrelia burgdorferi Antibodies, Total by ELISA
0.99 LIV or lessNegative - Antibody to B. burgdorferi not detected.
1.00-1.20 LIVEquivocal - Repeat testing in 10-14 days may be helpful.
1.21 LIV or greaterPositive - Probable presence of antibody to B. burgdorferi detected.

0050255Borrelia burgdorferi Antibody, IgG by ImmunoblotEffective August 15, 2011

0050253Borrelia burgdorferi Antibody, IgM by ImmunoblotEffective August 15, 2011


Interpretive Data
Refer to report.

This panel is appropriate for Lyme disease testing less than 4 weeks from erythema migrans or onset of disease symptoms.

A negative result indicates the immunoblot evaluation for B. burgdorferi antibody demonstrates no antibodies unique to B. burgdorferi and is, therefore, not supportive of Lyme disease.

A positive result indicates that the immunoblot evaluation for B. burgdorferi antibody is consistent with the presence of antibody produced by patients in response to infection by B. burgdorferi and suggests the presence of Lyme disease. Although the test has been shown to have a high degree of reliability for diagnostic purposes, laboratory data should always be correlated with clinical findings.

Current CDC recommendations for the serological diagnosis of Lyme disease are to screen with a polyvalent ELISA test and confirm equivocals and positives with immunoblot. Both IgM and IgG immunoblots should be performed on specimens obtained less than 4 weeks after appearance of erythema migrans. Only IgG immunoblot is to be performed on specimens greater than 4 weeks after disease onset. IgM immunoblot in the chronic stage is not recommended and does not aid in the diagnosis of neuroborreliosis or chronic Lyme disease.

If ELISA result is 1.00 LIV or greater, then IgG and IgM immunoblot will be added. Additional charges apply.
Hotline History
CPT Code(s)
86618; if reflexed, add 86617 x2
Component Test Code*Component Chart NameLOINC
0050216Borrelia burgdorferi Abs, Total by ELISA5060-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
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