Ordering Recommendation

Preferred reflex test to diagnose Lyme disease in symptomatic individuals. Reflex pattern follows the modified two-tier testing (MTTT) approach; a positive or equivocal screen is confirmed by immunoassay.

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, hemolyzed, or severely lipemic specimens.


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


Semiquantitative Enzyme-Linked Immunosorbent Assay




1-4 days

Reference Interval

Test Number
Reference Interval
  B. burgdorferi VlsE1/pepC10 Abs, ELISA 0.90 IV or less

Interpretive Data

Refer to report.

Component Interpretation
B. Burgdorferi VlsE1/pepC10 Abs, ELISA 0.90 IV or less; Negative - VlsE1 and pepC10 antibodies to B. burgdorferi not detected.
0.91-1.09 IV; Equivocal - Repeat testing in 10-14 days may be helpful.
1.10 IV or greater; Positive - VlsE1 and pepC10 antibodies to B. burgdorferi detected.

Compliance Category



If VlsE1/pepC10 antibodies by ELISA is 0.91 IV or greater, then IgM and IgG by ELISA will be added. Additional charges apply.

Hotline History


CPT Codes

86618; if reflexed, add 86618 x2


Component Test Code* Component Chart Name LOINC
3003258 B. burgdorferi VlsE1/pepC10 Abs, ELISA 100711-1
* 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 C6 peptide Ab reflex panel, Modified 2-tier testing
  • Lyme disease VlsE1/pepC10 Total Ab, ELISA reflex to IgM and IgM ELISAs
  • MTTT
  • VlsE lipoprotein, VlsE1/pepC10 assay
Borrelia burgdorferi VlsE1/pepC10 Antibodies, Total by ELISA With Reflex to IgM and IgG by ELISA (Modified Two-Tier Testing)