Autoimmune Neuromuscular Junction Reflexive Panel
Ordering Recommendation

Acceptable reflexive panel for the differential diagnosis of acquired neuromuscular junction disorders. Panel includes acetylcholine receptor binding, blocking, and modulating antibodies; voltage-gated calcium and potassium channels; titin antibody; striated muscle antibodies; and leucine-rich glioma-inactivated protein 1 antibody and contactin-associated protein-2 antibody IgG with reflex to titers.

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.
Submit With Order
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
Effective August 15, 2016
Test Number
Reference Interval
0080009Acetylcholine Receptor Binding Antibody
Negative0.0-0.4 nmol/L
Positive0.5 nmol/L or greater

0099580Acetylcholine Receptor Blocking AntibodyEffective November 18, 2013
Negative:0-26% blocking
Indeterminate:27-41% blocking
Positive:42% or greater blocking

0099521Acetylcholine Receptor Modulating AntibodyEffective August 20, 2012
Negative0-45% modulating
Positive46% or greater modulating

0092628Voltage-Gated Calcium Channel (VGCC) AntibodyEffective November 14, 2011
Negative0.0 to 24.5 pmol/L
Indeterminate24.6 to 45.6 pmol/L
Positive45.7 pmol/L or greater

2004890Voltage-Gated Potassium Channel (VGKC) Antibody
Negative31 pmol/L or less
Indeterminate32-87 pmol/L
Positive88 pmol/L or greater

2005636Titin AntibodyEffective January 17, 2012
Titin Antibody
Negative0.00-0.45 IV
Indeterminate0.46-0.71 IV
Positive0.72 IV or greater

0050746Striated Muscle Antibodies, IgG with Reflex to TiterLess than 1:40
2009460Leucine-Rich, Glioma-Inactivated Protein 1 Antibody, IgG and Contactin-Associated Protein-2 Antibody, IgG with Reflex to Titers
Test Number
Reference Interval
2009456Leucine-Rich, Glioma-Inactivated Protein 1 Antibody, IgG with Reflex to TiterRefer to report
2009452Contactin-Associated Protein-2 Antibody, IgG with Reflex to TiterRefer to report

Interpretive Data
Refer to report.

Compliance Statement A: For laboratory developed tests using a manufacturer labeled ASR as the reagent providing the specificity of the assay. Analyte Specific Reagent. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, the FDA has determined that such clearance or approval is not necessary.

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 detected, then a titer will be added.  If VGKC is Indeterminate or Positive, LGI1 Antibody IgG and CASPR2 Antibody IgG will be added. If LGI1 antibody IgG is positive, then LGI1 antibody IgG titer will be added. If CASPR2 antibody IgG is positive, then CASPR2 antibody IgG titer will be added. Additional charges apply.
Hotline History
CPT Code(s)
83519 x3; 83516 x2; 86255; if reflexed, add 83516 and/or 86256 and/or 86255x2, if further reflex add 86256 per titer
Component Test Code*Component Chart NameLOINC
0050747Striated Muscle Antibodies, IgG Screen49692-7
0080009Acetylcholine Binding Antibody11034-6
0092629Voltage-Gated Calcium Channel (VGCC) Ab33980-4
0099580Acetylcholine Blocking Antibody42937-3
2004890Voltage-Gated Potassium Channel (VGKC)Ab41871-5
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.
  • 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