Lyme Disease Antibody with Reflex to Blot (IgG, IgM)

Cleveland Heartlab L, Test


CPT Code: 86618
Order Code: C1473
Includes: Lyme Disease Ab Screen
If Lyme Disease Ab Screen is ≥0.90, then Lyme Disease Ab (IgG), Blot and Lyme Disease Ab (IgM), Blot will be performed at an additional charge (CPT Codes: 86617 x2).
ABN Requirement:
Synonyms: Borrelia burgdorferi
Specimen: Serum
Volume:  1.0 mL
Minimum Volume:  0.5 mL
Container: Gel-barrier tube (SST, Tiger Top)


  1. Collect and label sample according to standard protocols.
  2. Gently invert tube 5 times immediately after draw. DO NOT SHAKE.
  3. Let tube stand in a vertical position to allow blood to clot 30 minutes.
  4. Centrifuge for 10 minutes.

Transport: Store serum at 2-8°C after collection and ship the same day per packaging instructions included with the provided shipping box.


Ambient (15-25°C): 7 days
Refrigerated (2-8°C):
14 days
Frozen (-20°C):
30 days

Causes for Rejection: Specimens other than serum; improper labeling; samples not stored properly; samples older than stability limits; grossly hemolyzed, grossly lipemic, or grossly icteric samples

Methodology: Immunoassay (IA); Reflex: Immunoblot (IB)

Turn Around Time: 3 to 4 days

Reference Range:

Index Interpretation
Negative <0.90
Equivocal 0.91-1.09
Positive >1.09


Clinical Significance: Lyme Disease Antibody with Reflex to Blot (IgG, IgM) – Lyme disease is caused by a bacterium borrelia burgdorferi and is transmitted by ticks. A screening test with high sensitivity is used as the first step in the CDC recommended algorithm. Immunoblot testing qualitatively examines, with high specificity, antibodies in a patient’s specimen. Immunoblot testing is appropriate for confirming a detected screening result.

Additional Information: As recommended by the Food and Drug Administration (FDA), all samples with positive or equivocal results in a Borrelia burgdorferi antibody screen will be tested using a blot method. Positive or equivocal screening test results should not be interpreted as truly positive until verified as such using a supplemental assay (e.g., B. burgdorferi blot).The screening test and/or blot for B. burgdorferi antibodies may be falsely negative in early stages of Lyme disease, including the period when erythema migrans is apparent.

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.