Borrelia burgdorferi Total Antibodies, IgG and/or IgM by ELISA with Reflex to IgG by Western Blot (Late 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 Western blot.

Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Qualitative Western Blot
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 2 mL serum to an ARUP Standard Transport Tube. (Min: 0.1 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
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 lessNegative - Antibody to Borrelia 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 Borrelia burgdorferi detected.

0050255Borrelia burgdorferi Antibody, IgG by Western BlotEffective August 15, 2011


Interpretive Data
Refer to report.

This panel is appropriate for Lyme disease testing greater 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 EIA test and confirm equivocal and positive 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. Please submit requests for appropriate Western blot testing within 10 days.

If ELISA result is 1.00 LIV or greater, then IgG Western blot will be added. Additional charges apply.
CPT Code(s)
86618; if reflexed, add 86617
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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