Ordering Recommendation

Preferred CSF reflex panel for the workup of suspected neuroborreliosis.

New York DOH Approval Status

Testing is not New York state approved. Specimens from New York clients will be sent out to a New York state-approved laboratory.

Specimen Required

Patient Preparation

New York State Clients: CSF and serum separator tube (SST) or plain red. Serum specimen should be drawn within 24 hours of CSF collection.

Specimen Preparation

Transfer 6 mL CSF to an ARUP standard transport tube. (Min: 2.5 mL)
New York State Clients: Transfer 2 mL CSF (Min: 1 mL) to an ARUP standard transport tube AND transfer 2 mL serum to an ARUP standard transport tube.

Storage/Transport Temperature


Unacceptable Conditions

Bacterially contaminated, heat-inactivated, hemolyzed, or xanthochromic specimens.


Ambient: 8 hours; Refrigerated: 2 weeks; Frozen: 1 month (avoid repeated freeze/thaw cycles)


Semi-Quantitative Enzyme-Linked Immunosorbent Assay (ELISA)/Qualitative Immunoblot




1-4 days

Reference Interval

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

Interpretive Data

The detection of antibodies to Borrelia burgdorferi in cerebrospinal fluid may indicate central nervous system infection. However, consideration must be given to possible contamination by blood or transfer of serum antibodies across the blood-brain barrier. Lyme disease diagnosis in serum is recommended prior to any CSF studies.

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

Modified FDA


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

Hotline History


CPT Codes

86618; if reflexed, add 86617 x2


Component Test Code* Component Chart Name LOINC
3016821 B. burgdorferi VlsE1/pepC10 Abs, CSF 103961-9
* 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 CSF Abs Reflex Panel
Borrelia burgdorferi VlsE1/pepC10 Antibodies, CSF, Total by ELISA With Reflex to IgM and IgG by Immunoblot (Standard Two-Tier Testing, CSF)