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HelpTest Code LYMG Lyme Immunoassay, IgM and IgG
Useful For
Confirmation of Lyme serology positive and equivocal results.
Synonyms/Keywords
Lyme confirmation, Lyme IgM, Lyme IgG, B. burgdorferi
Specimen Requirements
| Fasting Required | Specimen Type | Preferred Container/Tube | Acceptable Container/Tube | Specimen Volume | Specimen Minimum Volume (allows for 1 repeat) |
Pediatric Minimum Volume (no repeat) |
|---|---|---|---|---|---|---|
| No | Serum | Red Top Tube (RTT) | Serum separator tube (SST) | 1 mL | 0.5 mL | 0.5 mL |
Acceptable Specimen Types
Serum
Collection/Processing Instructions
Separate serum from cells within 2 hours of collection
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum |
Refrigerated | 7 days |
| Frozen (-20 oC) | 3 months |
Rejection Criteria
Turbid sera, gross hemolysis, gross lipemia or bacterially contaminated samples
Test Components
IgM and IgG-class antibodies to B. burgdorferi (Lyme disease)
Test Information
This assay is for confirmation of a Lyme screen, as part of a modified two-tier test (MTTT) algorithm for Lyme disease (LD) serological testing. A report of Negative, Equivocal, or Positive for IgM & IgG anti-B. burgdorferi antibodies together with an interpretive comment will be made. Please see the Table below for interpretation. Note that the MTTT still suggests that IgM results in patients with > 30 days of the infection be disregarded, since a detectable IgM titer after that time may be due to non-specific cross-reactions.
Interpretations
Table: Guidance for the Interpretation of Lyme Disease (LD) MTTT Results
| Test Sequence | Interpretation for Providers | ||
| Lyme Screen | Confirmatory Lyme IgM | Confirmatory Lyme IgG | |
| Negative | Testing Not Indicated | Testing Not Indicated | No laboratory evidence of infection with B. burgdorferi (Lyme disease). Negative results may occur in patients recently infected (≤ 14 days) with B. burgdorferi. If recent infection is suspected, repeat testing in 7-14 days. |
| Positive/Equivocal | Negative | Negative | No laboratory evidence of infection with B. burgdorferi (Lyme disease). Negative results may occur in patients recently infected (≤ 14 days) with B. burgdorferi. If recent infection is suspected, repeat testing in 7-14 days. |
| Positive/Equivocal | Equivocal | Negative | Infection with B. burgdorferi (Lyme disease) cannot be ruled in or ruled out. Equivocal results may occur in patients recently infected (≤ 14 days) with B. burgdorferi. If recent infection is suspected, repeat testing in 7-14 days. |
| Positive/Equivocal | Positive | Negative | Results are consistent with acute or recent infection with B. burgdorferi (Lyme disease). IgM results should ONLY be considered as indicative of recent infections in patients presenting within 30 days of symptom onset. |
| Positive/Equivocal | Negative | Equivocal | Infection with B. burgdorferi (Lyme disease) cannot be ruled in or ruled out. If clinically indicated, consider repeat testing in 7-14 days. |
| Positive/Equivocal | Negative | Positive | Results are consistent with B. burgdorferi (Lyme disease) infection in the recent or remote past. |
| Positive/Equivocal | Positive | Positive | Results are consistent with B. burgdorferi infection (Lyme disease). |
| Positive/Equivocal | Equivocal | Equivocal | Infection with B. burgdorferi (Lyme disease) cannot be ruled in or ruled out. Equivocal results may occur in patients recently infected ( ≤14 days) with B. burgdorferi. If recent infection is suspected, repeat testing in 7-14 days. |
| Positive/Equivocal | Equivocal | Positive | Results are consistent with B. burgdorferi infection (Lyme disease) in the recent or remote past. |
| Positive/Equivocal | Positive | Equivocal | Results are consistent with a new infection with B. burgdorferi (Lyme disease). IgM results should ONLY be considered as indicative of recent infections in patients presenting within 30 days of symptom onset. |
(Adapted from APHL Suggested Reporting Language, Interpretation and Guidance Regarding Lyme disease Serologic Test Results.
https://www.aphl.org/aboutAPHL/publications/Documents/ID-2021-Lyme-Disease-Serologic-Testing-Reporting.pdf. Accessed 12/11/2023
Reference Range Information
Negative
Marshfield Labs Performing Department
Marshfield Labs Microbiology
Performing Information
| Performing Location | Day(s) Test Performed | Analytical Time | Methodology/Instrumentation |
|---|---|---|---|
| Marshfield | Monday through Friday | 1 day | Chemiluminescence immunoassay (Liaison XL) |
Outreach CPT Codes
| CPT | Modifier (if needed) |
Quantity | Description | Comments |
|---|---|---|---|---|
| 86617 |
|
2 | Lyme Confirmatory Immunoassay, IgM and IgG |
Ordering Applications
| Ordering Application | Description |
|---|---|
| Cerner | Lyme Confirmation |