Muscle Weakness Autoimmune Reflexive Panel
Ordering Recommendation
Acceptable reflexive panel for diagnosing myasthenia gravis. Panel contains binding, blocking, and modulating antibodies; voltage-gated calcium and potassium channels; titin antibody; and SMA IgG screen with titer.
Submit With Order
Quantitative Radioimmunoassay/Qualitative Radiobinding Assay/Semi-Quantitative Flow Cytometry/Semi-Quantitative Indirect Fluorescent Antibody
Refer to individual components
2-8 days
New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Serum separator tube (SST).  
Specimen Preparation
Separate serum from cells ASAP or within 2 hours of collection. Transport 2 mL serum. (Min: 1 mL)  
Storage/Transport Temperature
Unacceptable Conditions
Plasma. Contaminated, hemolyzed, or severely lipemic specimens.  
Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year  
Reference Interval
Test Number Components Reference Interval
0080009Acetylcholine Receptor Binding Antibody Negative: 0.0-​0.4 nmol/L
Positive: 0.5 nmol/L or greater
0099580Acetylcholine Receptor Blocking Antibody Effective November 18, 2013
Negative: 0-​26% blocking
Indeterminate: 27-​41% blocking
Positive: 42% or greater blocking
0099521Acetylcholine Receptor Modulating Antibody Negative: 0-​45% modulating
Positive: 46% or greater modulating

Effective August 20, 2012
0092628Voltage-​Gated Calcium Channel (VGCC) Antibody Effective November 14, 2011
Negative 0.0 to 24.5 pmol/L
Indeterminate 24.6 to 45.6 pmol/L
Positive 45.7 pmol/L or greater
2004890Voltage-​Gated Potassium Channel (VGKC) Antibody Effective April 18, 2011
Negative 31 pmol/L or less
Indeterminate 32-​87 pmol/L
Positive 88 pmol/L or greater
2005636Titin Antibody Effective January 17, 2012
Titin Antibody
Negative 0.00-​0.45 IV
Indeterminate 0.46-​0.71 IV
Positive 0.72 IV or greater
0050746Striated Muscle Antibody, IgG with Reflex to Titer Screen: < 1:40 No antibody detected.
Titer: < 1:40 No antibody detected.
Interpretive Data
In early-onset myasthenia gravis patients with anti-acetylcholine receptor antibodies, the presence of titin antibody indicates a 95-100 percent likelihood of an underlying thymoma.

Refer to Statement B under Testing Information at

See Compliance Statement D:
If Acetylcholine Receptor Binding Antibody result is greater than 0.4 nmol/L or Acetylcholine Receptor Blocking Antibody result is greater than 26 percent, then Acetylcholine Receptor Modulating Antibody will be added. If Striated Muscle Ab is greater than or equal to 1:40, then a titer will be added. Additional charges apply.
CPT Code(s)
83519; 83516; if reflexed, add 83516 x2; 83519 x2; 86255; if reflexed, add 86256
Component Test Code*Component Chart Name
0050747Striated Muscle Antibody, IgG Screen
0050748Striated Muscle Antibody, IgG Titer
0080009Acetylcholine Binding Antibody
0092629Voltage-Gated Calcium Channel (VGCC) Ab
0099580Acetylcholine Blocking Antibody
2004890Voltage-Gated Potassium Channel (VGKC)Ab
2005637Titin Antibody
* 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.
Cross References
  • AChR Binding Antibody
  • AChR Antibody
  • Anti-Skeletal Muscle IgG Antibodies
  • Anti-Striated Antibody
  • anti-tintin Ab
  • Muscle (Skeletal) Antibodies
  • Muscle nicotinic Acetylcholine Receptor
  • Myasthenia Gravis Antibodies
  • Myoid Antibody
  • Skeletal Muscle Antibodies
  • Striational Antibodies
  • VGCC Ab
  • VGKC Ab
  • Voltage-Gated Calcium Channel Antibody
  • Voltage-Gated Potassium Channel Antibody