Borrelia burgdorferi Antibodies, Total by ELISA with Reflex to IgG and IgM by Western Blot (Early Disease)
0050267
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 Western blot.
Mnemonic
LYME ACUTE
Methodology
Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Qualitative Western Blot
Performed
Sun-Sat
Reported
1-3 days  
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Specimen Required
Patient Preparation
  
Collect
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: 0.1 mL)  
Storage/Transport Temperature
Refrigerated.  
Unacceptable Conditions
CSF or plasma. Contaminated, heat-inactivated, hemolyzed, or severely lipemic specimens.  
Remarks
  
Stability
After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)  
Reference Interval
 
 
Test Number Components Reference Interval
0050216Borrelia burgdorferi Antibodies, Total by ELISA  
 
These reference intervals are to be used in the interpretation of Borrelia burgdorferi Total Antibodies, IgG and/or IgM by ELISA result
0.99 LIV or less Negative -​ Antibody to Borrelia burgdorferi not detected.
1.00-​1.20 LIV Equivocal -​ Repeat testing in 10-​14 days may be helpful.
1.21 LIV or greater Positive -​ Probable presence of antibody to Borrelia burgdorferi detected.
0050255Borrelia burgdorferi Antibody, IgG by Western Blot Effective August 15, 2011

Negative
0050253Borrelia burgdorferi Antibody, IgM by Western Blot Effective August 15, 2011

Negative
Interpretive Data
Refer to report.  
Note
This panel is appropriate for Lyme disease testing less than four weeks from erythema migrans or onset of disease symptoms.

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

A positive result indicates that the Western blot evaluation for Borrelia burgdorferi antibody is consistent with the presence of antibody produced by patients in response to infection by Borrelia 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 Western blot. Both IgM and IgG Western blots should be performed on specimens obtained less than four weeks after appearance of erythema migrans. 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 ELISA result is 1.00 LIV or greater, then IgG and IgM Western blot will be added. Additional charges apply.
CPT Code(s)
86618; if reflexed, add 86617 x2
Components
Component Test Code*Component Chart Name
0050216Borrelia burgdorferi Abs, Total by ELISA
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Aliases
  • Early Lyme Disease Ab Reflex
  • Lyme Disease
  • Lyme Disease Ab, ELISA to Western Blot
  • Lyme Disease Reflex Panel, Early Disease
  • Lyme Disease, Acute Reflexive Panel