Ordering Recommendation

Useful in the initial evaluation of neuromyelitis optica (NMO) spectrum disorders. This test uses a cell-based assay (CBA) to detect antibodies against aquaporin-4.




Semi-Quantitative Cell-Based Indirect Fluorescent Antibody


Mon, Wed, Fri


1-6 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation


Specimen Preparation

Transfer 0.5 mL CSF to an ARUP Standard Transport Tube. (Min: 0.15 mL)

Storage/Transport Temperature


Unacceptable Conditions

Hemolyzed, contaminated specimens or severely lipemic specimens.


Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year

Reference Interval

Less than 1:1

Interpretive Data

Diagnosis of neuromyelitis optica (NMO) requires the presence of longitudinally extensive acute myelitis (lesions extending over 3 or more vertebral segments) and optic neuritis. Approximately 75 percent of patients with NMO express antibodies to the aquaporin-4 (AQP4) receptor. While the absence of AQP4 receptor antibodies does not rule out a diagnosis of NMO, presence of this antibody is diagnostic for NMO.

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Laboratory Developed Test (LDT)


If AQP4 antibody IgG is positive, then an AQP4 antibody IgG titer is reported. Additional charges apply.

Hotline History


CPT Codes

86052; if reflexed, add 86256


Component Test Code* Component Chart Name LOINC
2011700 Neuromyelitis Optica/AQP4-IgG, CSF 46718-3
* 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.


  • AQP
  • AQP4
  • AQP4 antibody
  • Aquaporin; Devic's Ab
  • Cell-based assay
  • Cell-binding assay
  • CNS demyelinating disease
  • Devic's Antibody
  • Myelopathy
  • Neuromyelitis Optica (NMO) Antibody
  • Neuromyelitis Optica IgG
  • NMO-IgG
  • Optic Neuritis Ab
  • Optic Neuritis Antibody
  • Optic-Spinal MS Antibody
  • Pediatric CNS disorders
  • Soft-NMOS
  • Transverse Myelitis Ab
  • Vision Loss Ab
Aquaporin-4 Antibody, IgG by CBA-IFA, CSF with Reflex to Titer