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 immunoblot.




Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Qualitative Immunoblot




1-3 days

New York DOH Approval Status

This test is New York DOH approved.

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: 0.15 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
0050216 Borrelia burgdorferi Antibodies, Total by ELISA
0.99 LIV or less Negative - Antibody to B. 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 B. burgdorferi detected.

0050255 Borrelia burgdorferi Antibody, IgG by Immunoblot Effective August 15, 2011


Interpretive Data

Refer to report.

Compliance Category



This panel is appropriate for Lyme disease testing greater than 4 weeks from erythema migrans or onset of disease symptoms.

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

A positive result indicates that the immunoblot evaluation for B. burgdorferi antibody is consistent with the presence of antibody produced by patients in response to infection by B. 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 immunoblot. Both IgM and IgG immunoblots should be performed on specimens obtained less than 4 weeks after appearance of erythema migrans. Only IgG immunoblot is to 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.

If ELISA result is 1.00 LIV or greater, then IgG immunoblot will be added. Additional charges apply.

Hotline History


CPT Codes

86618; if reflexed, add 86617


Component Test Code* Component Chart Name LOINC
0050216 Borrelia burgdorferi Abs, Total by ELISA 5060-9
* 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.


  • Lyme Disease
  • Lyme Disease A ELISA Reflex to IgG WB
  • Lyme Disease Chronic Reflexive Panel
Borrelia burgdorferi Total Antibodies, IgG and/or IgM by ELISA with Reflex to IgG by Immunoblot (Late Disease)