Ordering Recommendation

Do not order in the absence of a positive or equivocal first-tier screening test for Lyme disease. 
Second-tier testing for use ≤4 weeks after symptom onset.

New York DOH Approval Status

This test is New York state approved.

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, severely hemolyzed, severely lipemic, and severely icteric specimens.


After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)


Qualitative Immunoblot




1-4 days

Reference Interval

Effective August 15, 2011


Interpretive Data

For this assay, a positive result is reported when any 2 or more of the following bands are present: 23, 39, or 41 kDa. All other banding patterns are reported as negative.

Compliance Category



Current CDC recommendations for the serologic diagnosis of Lyme disease are to screen with a polyvalent EIA test and confirm equivocal and positive with immunoblot.  Both IgM and IgG immunoblots should be performed on specimens less than 4 weeks after appearance of erythema migrans.  Only IgG immunoblot should 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. Please submit requests for appropriate immunoblot testing within 10 days.

Hotline History


CPT Codes



Component Test Code* Component Chart Name LOINC
0050253 B. burgdorferi Antibody IgM Immunoblot 6321-4
* 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.


  • Lyme Ab
  • Lyme Antibodies Detection
  • Lyme Antibodies IgM/IgG by Western Blot
  • Lyme Disease
  • Lyme Disease by PCR
Borrelia burgdorferi Antibody, IgM by Immunoblot