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.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation



Serum separator tube (SST) or plain red.

Specimen Preparation

Transfer 1 mL serum to an ARUP standard transport tube. (Min: 0.15 mL)

Storage/Transport Temperature


Unacceptable Conditions





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


Semi-Quantitative Cell-Based Indirect Fluorescent Antibody


Mon, Wed, Fri


1-6 days

Reference Interval

Less than 1:10

Interpretive Data

Neuromyelitis optic (NMO) commonly presents with optic neuritis or longitudinally extensive transverse myelitis. Approximately 75% of patients with NMO have 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 indirect fluorescent antibody assay utilizes AQP4 receptor transfected cell lines for the detection and semiquantification of AQP4 IgG antibody.

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
2013322 NMO/AQP4 Ab IgG CBA-IFA Screen, Serum 63439-4
* 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.


  • AQP
  • AQP4
  • AQP4 antibody
  • Aquaporin
  • Cell-based assay
  • Cell-binding assay
  • CNS demyelinating disease
  • Devic's Ab
  • 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 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum