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.

Mnemonic

LYME MTTT

Methodology

Semiquantitative Enzyme-Linked Immunosorbent Assay

Performed

Mon-Fri

Reported

1-4 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation
Collect

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

Refrigerated.

Unacceptable Conditions

CSF or plasma. Contaminated, heat-inactivated, hemolyzed, or severely lipemic specimens.

Remarks
Stability

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

Reference Interval

Test Number
Components
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

FDA

Note

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

N/A

CPT Codes

86618; if reflexed, add 86618 x2

Components

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.

Aliases

  • 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)