Reference Laboratory

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Reference Laboratory
Tests

88255

Enterovirus Serotyping

Enterovirus serotyping includes identification of the following: Coxsackie virus serotypes A9, A24, and B1-6; Echovirus serotypes 4, 6, 9, 11, and 30; Enterovirus serotypes 70 and 71; and Polioviruses 1, 2, and 3.

This test is approved for New York patient testing.

Methodology		Immunofluorescence
Reference Range		By report
Preferred Specimen		Cell culture isolate (minimum 0.5 mL)
Transport Temperature		FROZEN
Results Available		12 days
CPT Code		87140 x 5

-83

Epidemic Typhus (See Rickettsia [Typhus Fever Group])

52069

E. coli O157:H7 Culture with Reflex to Serotyping

This assay is a selective and differential culture for isolation of E. coli phenotypes that lack the ability to ferment sorbitol, a key characteristic of E. coli O157:H7 serotype. Most other serotypes of E. coli ferment sorbitol. Sorbitol negative isolates identified as E. coli will have O157:H7 serotyping performed at an additional charge. This test does not detect the disease associated Shiga- toxin nor does this test detect E. coli serotypes other than O157:H7 that may produce Shiga-toxin. Please request E. coli, Enterohemorrhagic (EHEC), Shiga-like toxin detection, EIA (Focus Unit Code 52068) if Shiga-toxin testing is required. For culture of E. coli other than O157:H7, please refer to Focus test “Bacterial Culture, Aerobic, Special” (Focus Unit Code 51250) and request E. coli. For serotyping E. coli isolates for O157:H7, refer to Focus test “E. coli O157:H7 Serotyping” (Focus Unit Code 52065).

This test is not approved for New York patient testing.

Methodology		Culture and latex agglutination
Reference Range		No E. coli O157:H7 Isolated
Preferred Specimen		5 grams stool in Cary-Blair transport medium (minimum 1 gram)
Transport Temperature		Room temperature
Results Available		3 to 6 days
CPT Code		87046 (Add 87147 if serotyping performed)

47440

Enterovirus/Parechovirus RNA, Qualitative Real-Time PCR

This assay detects all known enteroviruses and parechoviruses. These viruses are a common cause of nonspecific febrile illness and meningitis in children and adults. Parechoviruses are genetically distinct from enteroviruses and will not be detected in a pan-enterovirus RT-PCR assay.

This test is not approved for New York patient testing.

Methodology		Real-Time RT-PCR
Reference Range		Not detected
Preferred Specimen		0.7 mL CSF, plasma (EDTA or ACD), serum (minimum 0.3 mL) OR 1 gram stool (minimum 0.5 gram) OR 1 throat or rectal swab
Transport Temperature		Stool: FROZEN All others: 2-8° C
Results Available		1 to 3 days
CPT Code		87498; 87798

20193

Epidermal (Skin) Antibody, IFA

This assay tests for two antibody specificities:
1. Antibody to intercellular substance of the epidermis. This antibody strongly suggests the diagnosis of pemphigus (all forms), although it may be rarely present in burn patients and trichophyton infections. The rise and fall of the titer may be indicative of relapse and remission of the disease respectively.
2. Antibody to the dermal-epidermal basement membrane. This antibody is highly specific for bullous pemphigoid and is present in 80% of these patients.

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:10
Preferred Specimen		1 mL serum (minimum 0.1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86255 x 2

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52066

E. coli, Culture Screen, Stool


This unit code has been inactivated. Please see unit code 52069.

47510

Epstein Barr Virus DNA, Qualitative Real-Time PCR

The detection of Epstein-Barr virus (EBV) DNA is based upon the real-time amplification and detection of specific EBV genomic DNA sequences by PCR from total DNA extracted from the specimen.

This test is approved for New York patient testing.

Methodology		Real-Time PCR
Reference Range		Not detected
Preferred Specimen		1 mL whole blood (EDTA, ACD), plasma (EDTA, ACD, PPT), serum, CSF, bone marrow (minimum 0.3 mL) OR 3 mm³ tissue
Transport Temperature		Whole blood and bone marrow: Room temperature All others: FROZEN
Results Available		Next day
CPT Code		87798

48453

Epstein Barr Virus DNA, Quantitative Real-Time PCR

Quantitation of EBV DNA is based upon the real-time PCR amplification and detection of EBV genomic DNA. The quantitative range of this assay is from 200 to 2,000,000 EBV DNA copies/mL.

This test is approved for New York patient testing.

Methodology		Real-Time PCR
Reference Range		<200 copies/mL
Preferred Specimen		1 mL whole blood (EDTA, ACD), plasma (EDTA, ACD, PPT), serum, CSF, bone marrow (minimum 0.5 mL)
Transport Temperature		Whole blood or bone marrow: Room temperature All others: FROZEN
Results Available		Next day
CPT Code		87799

52065

E. coli O157:H7 Serotyping

E. coli O157:H7 has emerged as an enteric pathogen of public health importance causing outbreaks of diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome. Although multiple serotypes have been reported to cause disease, the O157:H7 serotype is the most common single strain isolated. Not all O157 strains have the H7 flagellar antigen. This test is performed to confirm identification of the O157:H7 serotype of E. coli. To confirm or detect Shiga-toxin activity of an E. coli O157:H7 isolate, the Shiga-toxin detection EIA is recommended. Please request E. coli, Enterohemorrhagic (EHEC), Shiga-Like Toxin EIA (Focus Unit Code 52068) if toxin detection is required.

This test is approved for New York patient testing.

Methodology		Agglutination
Reference Range		Negative for O157:H7
Preferred Specimen		Pure culture of E. coli safely contained.
Transport Temperature		Room temperature
Results Available		3 to 5 days
CPT Code		87147

47599

Epstein Barr Virus DNA, Qual to Quant Real-Time PCR Reflex

If EBV DNA is detected in the qualitative assay, the specimen will reflex to EBV Quantitative PCR (Focus Unit Code 48453) for an additional charge. The quantitative range if reflexed is 200 - 2,000,000 EBV DNA copies/mL.

This test is approved for New York patient testing.

Methodology		Real-Time PCR
Reference Range		Not detected
Preferred Specimen		1 mL whole blood (EDTA, ACD), plasma (EDTA, ACD, PPT), serum, CSF, bone marrow (minimum 0.5 mL)
Transport Temperature		Whole blood or bone marrow: Room temperature All others: FROZEN
Results Available		Next day
CPT Code		87798 (Add 87799 if reflexed)

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40485

Epstein-Barr Nuclear Antigen (EBNA) Antibody, ACIF (Serum)

Antibody to the EBV nuclear antigen (EBNA) appears no earlier than 3-4 weeks post-onset of primary EBV infection, with many patients requiring several months to produce detectable antibody. Titers >=1:160 generally rule out a diagnosis of primary EBV infection.

This test is approved for New York patient testing.

Methodology		ACIF (Anti-Complement Immunofluorescence)
Reference Range		<1:10
Preferred Specimen		1 mL serum (minimum 0.10 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86664

52068

E. coli, Enterohemorrhagic (EHEC), Shiga-like Toxin Detection, EIA

Enterohemorrhagic E. coli (EHEC) have been isolated from patients with hemorrhagic colitis and hemolytic-uremic syndrome, and can produce bloody diarrhea secondary to toxin damage of vascular endothelial cells. A large portion of EHEC isolates belong to the serotype 0157:H7, although at least 50 other EHEC serotypes have been reported. All EHEC strains produce potent cytotoxins called Shiga-like toxins or verotoxins, which are biochemically similar to the Shiga toxin produced by strains of Shigella dysenteriae serotype 1. This very sensitive assay detects the presence of Shiga-like Toxins 1 and 2 directly in stool specimens or culture systems.

This test is approved for New York patient testing.

Methodology		EIA (Enzyme Immunoassay)
Reference Range		Negative
Preferred Specimen		1 gram stool in Cary-Blair transport medium OR Broth culture OR Culture isolate
Transport Temperature		Stool specimens and broth cultures: Up to 3 days: 2-27° C >3 days: FROZEN at -70° C Viable culture isolates: room temperature or 2-27° C
Results Available		1 to 4 days
CPT Code		87427

60485

Epstein-Barr Nuclear Antigen (EBNA) Antibody, ACIF (CSF)

Detection of intrathecally-produced organism-specific antibodies in CSF indicates central nervous system infection. However, serum levels of organism-specific antibodies, blood-brain barrier integrity, and possible CSF contamination by blood should be considered when assessing CSF results.

This test is approved for New York patient testing.

Methodology		ACIF (Anti-Complement Immunofluorescence)
Reference Range		<1:2
Preferred Specimen		1 mL CSF (minimum 0.25 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86664

40497

Epstein-Barr Nuclear Antigen (EBNA) IgM, ELISA

EBNA IgM is often detected in recent or current Epstein Barr Virus (EBV) infection. However, EBNA IgM is also found in 2-12% of healthy adults, depending on age and geographic location.

This test is approved for New York patient testing.

Methodology		ELISA (Enzyme Linked Immunosorbent Assay)
Reference Range		<0.90
Preferred Specimen		0.5 mL serum (minimum 0.25 mL)
Transport Temperature		Room temperature
Results Available		5 to 8 days
CPT Code		86664

40460

Epstein-Barr Viral Capsid Antigen (VCA) IgG and IgM Antibody, IFA (Serum)

Both IgG and IgM antibody levels are titered. A four-fold increase in VCA-lgG or a VCA-lgM titer >=1:20 is indicative of current infection.

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		IgG <1:10 IgM <1:20
Preferred Specimen		1 mL serum (minimum 0.10 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86665 x 2

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60460

Epstein-Barr Viral Capsid Antigen (VCA) Antibody, IFA (CSF)

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		IgG <1:64 IgM <1:1
Preferred Specimen		1 mL CSF (minimum 0.25 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86665 x 2

40465

Epstein-Barr Viral Capsid Antigen (VCA) IgG Antibody, IFA (Serum)

EBV VCA IgG and IgM are stimulated in virtually all primary EBV infections. VCA-IgM appears immediately after onset of symptoms and usually disappears within 2-3 months. VCA-IgG appears immediately after onset of symptoms and persists indefinitely, falling gradually with time unless restimulated as in reactivated infection and chronic disease.

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:10
Preferred Specimen		1 mL serum (minimum 0.10 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86665

81090

E. coli, Verotoxin (Shiga-like Toxin) Detection, CC


This unit code has been inactivated. Please see unit code 52068.

40417

Eastern Equine Encephalitis Virus Antibody, IFA (Serum)

IgG titers >=1:16 suggest exposure, while the presence of IgM indicates recent infection. Human infections are seasonal, from mid- to late-summer, occurring from New England to Texas. Minimal crossreactivity with other Group A arboviruses, i.e., Western Equine Encephalitis virus, occurs.

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		IgG <1:16 IgM <1:16
Preferred Specimen		1 mL serum (minimum 0.075 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86652 x 2

60417

Eastern Equine Encephalitis Virus Antibody, IFA (CSF)

This test is available for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		IgG <1:4 IgM <1:4
Preferred Specimen		1 mL CSF (minimum 0.1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86652 x 2

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60465

Epstein-Barr Viral Capsid Antigen (VCA) IgG Antibody, IFA (CSF)

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:64
Preferred Specimen		1 mL CSF (minimum 0.1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86665

40420

Eastern Equine Encephalitis Virus IgG Antibody, IFA (Serum)

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:16
Preferred Specimen		1 mL serum (minimum 0.075 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86652

40446

Epstein-Barr Viral Capsid Antigen (VCA) IgG and IgA Antibody Panel, IFA

VCA-IgG appears immediately after onset of symptoms and persists indefinitely. VCA-IgA titers between 1:10 and 1:80 suggest past infection, whereas titers greater than 1:80 suggest chronic infection.

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		IgG <1:10 IgA <1:10
Preferred Specimen		2 mL serum (minimum 0.25 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86665 x 2

40470

Epstein-Barr Viral Capsid Antigen (VCA) IgM Antibody, IFA (Serum)

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:20
Preferred Specimen		1 mL serum (minimum 0.10 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86665

60420

Eastern Equine Encephalitis Virus IgG Antibody, IFA (CSF)

This test is available for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:4
Preferred Specimen		1 mL CSF (minimum 0.1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86652

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40425

Eastern Equine Encephalitis Virus IgM Antibody, IFA (Serum)

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:16
Preferred Specimen		1 mL serum (minimum 0.075 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86652

60470

Epstein-Barr Viral Capsid Antigen (VCA) IgM Antibody, IFA (CSF)

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:1
Preferred Specimen		1 mL CSF (minimum 0.1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86665

40475

Epstein-Barr Virus Early Antigen (R+D) IgG, IFA (Serum)

A transient elevation in titer is seen in 85% of acute EBV infections. Although titer increases may appear at a later date due to an asymptomatic viral reactivation, elevated levels (>=1:640) may also be related to chronic or reactivated EBV. Titers are also elevated in Burkitt's lymphoma and nasopharyngeal carcinoma.

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:10
Preferred Specimen		1 mL serum (minimum 0.10 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86663

60425

Eastern Equine Encephalitis Virus IgM Antibody, IFA (CSF)

This test is available for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:4
Preferred Specimen		1 mL CSF (minimum 0.1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86652

40430

Echinococcus Antibody (IgG)

Detection of serum antibodies to Echinococcus plays an important role in the diagnosis of hydatid disease, since infected individuals do not exhibit fecal shedding of Echinococcus eggs. Increasing antibody values between acute and convalescent specimens is considered evidence of recent or current infection. The frequency of a positive result for serum antibodies to Echinococcus is higher in patients with active cysts in the liver than in patients with hydatid cysts in the lung or calcified cysts. Serologic crossreactivity between Echinococcus and Cysticercus may occur.

This test is approved for New York patient testing.

Methodology		ELISA (Enzyme Linked Immunosorbent Assay)
Reference Range		<=0.80
Preferred Specimen		1 mL serum (minimum 0.1 mL)
Transport Temperature		Room temperature (Do not reject refrigerated or frozen specimens)
Results Available		1 to 8 days
CPT Code		86682

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60475

Epstein-Barr Virus Early Antigen (R+D) IgG, IFA (CSF)

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:4
Preferred Specimen		1 mL CSF (minimum 0.25 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86663
Sample Report(s)		Positive Negative

40515

Epstein-Barr Virus (EBV) Antibody Panel, MAID


This unit code has been inactivated. Please see unit code 2420.

40435

Echovirus Antibodies, Serum

The current Echovirus panel includes serotypes 4, 7, 9, 11 and 30. The Echovirus serotypes used in this panel will vary depending upon current epidemiological data available from in-house isolations and CDC reports. Generally, the serotypes used are those most commonly associated with viral meningitis. Although there is crossreactivity among the enteroviruses, most healthy people do not have detectable CF titers (>1:8). Therefore, detectable titers, especially those >=1:32, should be considered a positive identification. Confirmation is made by demonstration of a four-fold change in titers between acute and convalescent sera. See Unit Code 4403 for parallel testing.

This test is approved for New York patient testing.

Methodology		CF (Complement Fixation)
Reference Range		<1:8
Preferred Specimen		1 mL serum (minimum 0.5 mL)
Transport Temperature		Room temperature
Results Available		2 to 5 days
CPT Code		86658 x 5

40440

Epstein-Barr Virus (EBV) Antibody Panel, Primary, IFA (Serum)

The primary panel is used for the diagnosis of acute primary EBV infection. It includes Epstein-Barr nuclear antigen (EBNA) antibody at a dilution of 1:10, as well as IgG and IgM antibodies to the viral capsid antigen (VCA) at dilutions of 1:10 and 1:20 respectively.
Acute Infection Primary Infection Past Infection
Months 1 2 3
VCA-IgG >=1:10 >=1:10 >=1:10
VCA-IgM >=1:20 <1:20 <1:20
EBNA ACIF <1:10 <1:10 >=1:10

EBV VCA IgG and IgM are stimulated in virtually all primary EBV infections. VCA-IgM appears immediately after onset of symptoms and usually disappears within 2-3 months. VCA-IgG appears immediately after onset of symptoms and persists indefinitely, falling gradually with time unless restimulated as in reactivated infection and chronic disease. EBNA antibody can be detected 2-6 months after acute illness, and usually persists for life.

Methodology		IFA (Immunofluorescence Assay) and ACIF (Anti-Complement Immunofluorescence)
Reference Range		By report
Preferred Specimen		2 mL serum (minimum 1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86664; 86665 x 2

60435

Echovirus Antibodies, CSF

This test is approved for New York patient testing.

Methodology		Complement Fixation
Reference Range		<1:1
Preferred Specimen		2 mL CSF (minimum 1 mL)
Transport Temperature		2-8° C
Results Available		2 to 5 days
CPT Code		86658 x 5

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40480

Epstein-Barr Virus Viral Capsid Antigen (VCA) Antibody (IgA)

VCAIgA titers above the reference range are suggestive of chronic or reactivated EBV infection. Detectable titers within the reference range are due to past infection.

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:10
Preferred Specimen		1 mL serum (minimum 0.25 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86665

6044

Epstein-Barr Virus (EBV) Antibody Panel, Primary, IFA (CSF)

See individual assay for description.

Panel Includes:

Epstein-Barr Nuclear Antigen (EBNA) Antibody, ACIF
Epstein-Barr Virus (EBV) VCA and IgM Antibody Panel IFA

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		By report
Preferred Specimen		2 mL CSF (minimum 1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86664; 86665 x 2

4403

Echovirus Antibodies Parallel Testing, Serum


This unit code has been inactivated. Please see unit code 40435.

-74

Echovirus PCR (See Enterovirus RNA, Qualitative, PCR)

Enterovirus RNA, Qualitative Real-Time PCR

40445

Epstein-Barr Virus (EBV) Antibody Panel, Secondary, IFA

This panel detects antibody responses to EBV which may suggest chronic infection. Specimens with titers above the reference ranges (see below) are suggestive of chronic or reactivated EBV infection. Titers within the reference ranges are due to past infection.
Reference Range
VCA IgG-IFA: 1:10-1:2560
VCA IgA-IFA: 1:10-1:80
EA (R + D) IgG-IFA: 1:10-1:320

Many cases of chronic EBV disease display elevated EBV titers. However, it is difficult to diagnose serologically due to the variations of antibody responses possible. The Viral Capsid Antigen (VCA) IgG appears immediately after primary infection and persists indefinitely, falling gradually with time unless restimulated as in reactivated infection or chronic disease. The VCA-IgA is considered an acute phase antibody and its presence at elevated levels may be related to chronic or reactivated EBV infection. Titers to EA are generally detectable at onset of acute primary disease and begin to fall in 3-6 months. However, many cases of chronic EBV disease display elevated EA titers.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		By report
Preferred Specimen		2 mL serum (minimum 1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86663 x 2; 86665

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-75

Ehrlichia canis Antibody (See Ehrlichia chaffeensis)

51895

Erythromycin Level, BA

Specimens collected just before or within 15 minutes of the next dose represent the TROUGH levels. Specimens obtained within 15-30 minutes after the end of I.V. infusion or 45-60 minutes after an IM injection or 90 minutes after oral intake represent the PEAK level.

This test is available for New York patient testing.

Methodology		Bioassay
Reference Range		By report
Preferred Specimen		1 mL serum (minimum 0.5 mL)
Transport Temperature		FROZEN
Results Available		3 to 4 days
CPT Code		80299

2420

Epstein-Barr Virus (EBV) Panel, IFA (Serum)

See individual assay for description.

Panel Includes:

Epstein-Barr Nuclear Antigen (EBNA) Antibody, ACIF
Epstein-Barr Viral Capsid Antigen IgG and IgM Antibody, IFA
Epstein-Barr Virus Early Antigen (R+D) IgG, IFA

Methodology		IFA (Immunofluorescence Assay)
Reference Range		By report
Preferred Specimen		2 mL serum (minimum 1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86663; 86664; 86665 x 2

6420

Epstein-Barr Virus (EBV) Panel, IFA (CSF)

See individual assay for description.

Panel Includes:

Epstein-Barr Nuclear Antigen (EBNA) Antibody, ACIF
Epstein-Barr Viral Capsid Antigen IgG and IgM Antibody, IFA
Epstein-Barr Virus Early Antigen (R+D) IgG, IFA

Methodology		IFA (Immunofluorescence Assay)
Reference Range		By report
Preferred Specimen		2 mL CSF (minimum 1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86663; 86664; 86665 x 2

23100

Ehrlichia chaffeensis DNA Real-Time PCR

Ehrlichia chaffeensis DNA detection is based on real-time PCR, a highly sensitive method to detect the presence of microbial nucleic acid in clinical specimens.

This test is not approved for New York patient testing.

Methodology		Real-Time PCR
Reference Range		Not detected
Preferred Specimen		0.7 mL whole blood (ACD or EDTA) (minimum 0.3 mL) OR tick (in ethanol or live) (minimum 1 tick)
Transport Temperature		2-8°C
Results Available		1 to 3 days
CPT Code		87798

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1200

Epstein-Barr Virus (EBV) Screening Panel, IFA

See individual assay for description.

Panel Includes:

Epstein-Barr Nuclear Antigen (EBNA) Antibody, ACIF
Epstein-Barr Viral Capsid Antigen (VCA) IgG Antibody, IFA
Epstein-Barr Virus Early Antigen (R+D) IgG, IFA

Methodology		IFA (Immunofluorescence Assay)
Reference Range		By report
Preferred Specimen		2 mL serum or CSF (minimum 1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86663; 86664; 86665

20103

Ehrlichia chaffeensis Antibodies (IgG, IgM)

Ehrlichia chaffeenis has been identified as the causative agent of Human Monocytic Ehrlichiosis (HME). Infected individuals produce specific antibodies to E. chaffeensis that can be detected by an immunofluorescent antibody (IFA) test. Single IgG IFA titers of 1:64 or greater indicate exposure to E. chaffeensis. A four-fold rise in IgG titers between acute and convalescent samples and/or the presence of IgM antibody against E. chaffeensis suggest recent or current infection.

†This test was developed and its performance characteristics determined by Focus Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test.

This test is approved for New York patient testing.

Methodology		IFA (Immunofluorescence Assay)
Reference Range		IgG <1:64 IgM <1:20
Preferred Specimen		1 mL serum (minimum 0.2 mL)
Transport Temperature		2-8° C
Results Available		1 to 3 days
CPT Code		86666 x 2†

-85

Erythrovirus (See Parvovirus)

52113

Extended-Spectrum Beta-Lactamase (ESBL) Detection, DD

Genes associated with beta-lactamase-mediated ampicillin resistance in E. coli and Klebsiella pneumoniae can undergo simple point mutations that result in the production of beta-lactamases that are capable of hydrolyzing broad spectrum beta-lactam antibiotics such as ceftazidime, cefotaxime, ceftriaxone, and aztreonam. These plasmid-mediated extended spectrum beta-lactamases (ESBLs) are generally inhibited by beta-lactamase inhibitors, e.g., clavulanic acid, sulbactam, and tazobactam, and are currently not active against cefamycins and carbapenems. ESBLs have been most commonly documented in E. coli and Klebsiella pneumoniae strains, but reports have indicated their spread to other species of the family Enterobacteriaceae.

Detection of ESBL expression has proven to be difficult for many laboratories, and the CLSI (formerly NCCLS) has recommended specific criteria for ESBL confirmation using the preferred substrates ceftazidime and cefotaxime. These two antimicrobial agents, alone and in combination with clavulanic acid, are tested by standard disk diffusion methods, and a >=5 mm increase in zone diameter for either antimicrobial agent tested in combination with clavulanic acid versus its zone when tested alone is confirmatory for the presence of ESBL. This method has been recommended for use only with E. coli and Klebsiella spp. and may not be appropriate for other enteric gram-negative bacilli. If ESBL production is confirmed, the bacterial isolate should be considered as resistant to all penicillins, cephalosporins, and aztreonam.

This test is approved for New York patient testing.

Methodology		Disk Diffusion
Reference Range		Not detected
Preferred Specimen		Pure culture of E. coli or Klebsiella spp., safely contained.
Transport Temperature		Room temperature
Results Available		2 to 4 days
CPT Code		87184

43300

Ehrlichia ewingii DNA, Real-Time PCR

One of the causes of granulocytic ehrlichiosis in dogs, E. ewingii is now known to cause human infection as well. Disease is transmitted by the lone star tick and less commonly by other tick species. As with E. chaffeensis, human disease is seen predominantly in the southeastern and south-central parts of the U.S. Clinical symptoms include fever, headache, and thrombocytopenia, with or without leucopenia.

This test is not approved for New York patient testing.

Methodology		Real-Time PCR
Reference Range		Not detected
Preferred Specimen		0.7 mL whole blood (EDTA OR ACD) (minimum 0.3 mL) OR 1 Tick
Transport Temperature		2-8°C
Results Available		1 to 3 days
CPT Code		87798

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-76

Ehrlichiosis (See Anaplasma phagocytophilum and Ehrlichia chaffeensis)

Anaplasma phagocytophilum and Ehrlichia chaffeensis Antibody Panel

-77

ENA Antibodies (See Individual Listing Under SS-A, SS-B, Sm or RNP)

-78

ENA Panel (See Extractable Nuclear Antigen Antibody Panel)

Extractable Nuclear Antigen (ENA) Antibody Panel, MAID

2750

Extractable Nuclear Antigen (ENA) Antibody Panel, MAID

See individual assay for description.

Panel Includes:

RNP and Sm Antibodies IgG, MAID
Scl-70 Antibody IgG, MAID
SS-A and SS-B IgG Antibodies, MAID

Methodology		MAID (Multi-Analyte Immunodetection)
Reference Range		Negative
Preferred Specimen		3 mL serum (minimum 1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86235 x 5

-79

Encephalitis (See also Meningioencephalitis Panel)

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2405

Encephalitis Antibody Panel (Serum)

See individual assay for description.

Panel Includes:

Herpes Simplex Virus (HSV) 1/2 IgM and Type-Specific IgG (HerpeSelect�), ELISA
Lymphocytic Choriomeningitis (LCM) IgG and IgM Antibody, IFA
Measles (Rubeola) IgG and IgM Antibody Panel, IFA
Mumps IgG and IgM Antibody, IFA and
Varicella-Zoster Virus Antibody Total and IgM, ACIF/IFA

Methodology		ACIF (Anti-Complement Immunofluorescence), IFA (Immunofluorescence Assay), ELISA (Enzyme Linked Immunosorbent Assay)
Reference Range		By report
Preferred Specimen		3 mL serum (minimum 1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86694; 86695; 86696; 86727 x 2; 86735 x 2; 86765 x 2; 86787 x 2

6405

Encephalitis Antibody Panel (CSF)

See individual assay for description.

Panel Includes:

Herpes Simplex Virus (HSV) 1/2 Antibody, ACIF
Herpes Simplex Virus (HSV) 1/2 IgM Panel, IFA
Lymphocytic Choriomeningitis (LCM) IgG and IgM Antibody, IFA
Measles (Rubeola) IgG and IgM Antibody Panel, IFA
Mumps IgG and IgM Antibody, IFA
Varicella-Zoster Virus Antibody Total and IgM, ACIF/IFA

Methodology		ACIF (Anti-Complement Immunofluorescence) and IFA (Immunofluorescence Assay)
Reference Range		By report
Preferred Specimen		3 mL CSF (minimum 1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86695 x 2; 86696 x 2; 86727 x 2; 86735 x 2; 86765 x 2; 86787 x 2

-80

Endemic Typhus (See Rickettsia [Typhus Fever Group])

20594

Endomysial IgA Antibody, IFA

IgA endomysial antibody is present in approximately 70% of dermatitis herpetiformis (DH) patients and nearly 100% of celiac disease patients not on gluten-free diets. Decreasing antibody titers correlate with adherence to a gluten-free diet.

This test is approved for New York patient testing.

Please see the following technical sheet for more information:

Serologic Tests for Celiac Disease

Methodology		IFA (Immunofluorescence Assay)
Reference Range		<1:5
Preferred Specimen		1 mL serum (minimum 0.1 mL)
Transport Temperature		2-8° C
Results Available		1 to 4 days
CPT Code		86255

-81

Endotoxin (See Limulus Amebocyte Lysate)

Limulus Amebocyte Lysate (LAL) Assay, Quantitative

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50105

Entamoeba histolytica Antigen, EIA

The detection of Entamoeba histolytica antigen by immunoassay is a highly sensitive and specific test. It is extremely useful in cases of amebiasis where ova and parasite examinations are inconclusive. This assay will detect only the antigen of the pathogenic E. histolytica; it will not detect the non-pathogenic E. dispar.

This test is approved for New York patient testing.

Methodology		EIA (Enzyme Immunoassay)
Reference Range		Negative
Preferred Specimen		1 gram fresh unpreserved stool <=48 hours post collection. Cary-Blair transport medium is not acceptable (minimum 1 gram)
Transport Temperature		2-8° C <48 hours or FROZEN >48 hours
Results Available		1 to 3 days
CPT Code		87337

40105

Entamoeba histolytica IgG, ELISA

Serologic studies may be helpful in the diagnosis of invasive intestinal and extra-intestinal amebiasis. Asymptomatic cyst passers usually have negative serologic tests. Eighty-five percent of patients with biopsy proven invasive intestinal amebiasis are antibody positive whereas 95-100% of patients with extra-intestinal amebiasis are positive. Values may remain elevated 6 to 18 months following invasive disease.

This test is approved for New York patient testing.

Methodology		ELISA (Enzyme Linked Immunosorbent Assay)
Reference Range		<1.00
Preferred Specimen		1 mL serum (minimum 0.25 mL)
Transport Temperature		Room temperature
Results Available		1 to 8 days
CPT Code		86753

40106

Entamoeba histolytica Antibody, ID


This unit code has been inactivated. Please see unit code 40105.

-82

Enterovirus (for Serology, see Echovirus, Coxsackie and/or Poliovirus,
for Virus Isolation, see Viral Culture and Identification)

47300

Enterovirus RNA, Qualitative Real-Time PCR

Reverse transcriptase-PCR (RT-PCR) is a highly sensitive method used to detect Enterovirus (EV) RNA from various clinical specimens. This assay targets a conserved region of the EV genome which allows detection of nearly the entire spectrum of human Enteroviruses, including the Coxsackieviruses, Polioviruses and the Echoviruses. It does not differentiate among the EV serotypes.

This test is not approved for New York patient testing.

Methodology		Real-Time RT-PCR
Reference Range		Not detected
Preferred Specimen		0.7 mL CSF, serum, plasma (ACD, EDTA or PPT); throat or rectal swab in M4 or V-C-M medium OR 1 gm stool (minimum 0.3 mL)
Transport Temperature		Stool: FROZEN Others: 2-8° C
Results Available		1 to 3 days
CPT Code		87498

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2075

Enterovirus Panel I, CF (Serum)

See individual assay for description.

Panel Includes:

Coxsackie Type B Antibody Panel, CF
Echovirus Antibody Panel, CF
Poliovirus (Types 1-3) Antibody, CF

Methodology		CF (Complement Fixation)
Reference Range		<1:8
Preferred Specimen		3 mL serum (minimum 2 mL)
Transport Temperature		Room temperature
Results Available		2 to 5 days
CPT Code		86658 x 14

6075

Enterovirus Panel I, CF (CSF)

See individual assay for description.

Panel Includes:

Coxsackie Type B Antibody Panel, CF
Echovirus Antibody Panel, CF
Poliovirus (Types 1-3) Antibody, CF

Methodology		CF (Complement Fixation)
Reference Range		<1:1
Preferred Specimen		3 mL CSF (minimum 2 mL)
Transport Temperature		2-8° C
Results Available		2 to 5 days
CPT Code		86658 x 14

2080

Enterovirus Panel II, CF (Serum)

See individual assay for description.

Panel Includes:

Coxsackie Type A Antibody Panel, CF
Coxsackie Type B Antibody Panel, CF
Echovirus Antibody Panel, CF
Poliovirus (Types 1-3) Antibody, CF

Methodology		CF (Complement Fixation)
Reference Range		By report
Preferred Specimen		3 mL serum (minimum 2 mL)
Transport Temperature		2-8° C
Results Available		2 to 5 days
CPT Code		86658 x 20

6080

Enterovirus Panel II, CF (CSF)

See individual assay for description.

Panel Includes:

Coxsackie Type A Antibody Panel, CF
Coxsackie Type B Antibody Panel, CF
Echovirus Antibody Panel, CF
Poliovirus (Types 1-3) Antibody, CF

Methodology		CF (Complement Fixation)
Reference Range		By report
Preferred Specimen		3 mL CSF (minimum 2 mL)
Transport Temperature		2-8° C
Results Available		2 to 5 days
CPT Code		86658 x 20

88250

Enterovirus Culture, Rapid

The Enterovirus Culture utilizes two genetically transformed cell lines for enhanced viral recovery and more rapid viral detection when compared to conventional cell line methods. If isolated, Enterovirus will be identified using a pan-enterovirus fluorescent antibody stain method.

This test is approved for New York patient testing.

Methodology		Tissue Culture/Immunofluorescence
Reference Range		None isolated
Preferred Specimen		1 mL Nasopharyngeal aspirate, wash, or BAL; throat swab, or stool swab in Viral Transport Media OR 1mL CSF, undiluted. (minimum 0.5 mL)
Transport Temperature		2-8° C
Results Available		10 days
CPT Code		87254

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88125

Enterovirus Rapid Culture and Serotyping (72 Hours)


This unit code has been inactivated. Please see unit code 88250.

First FDA Clearance of a 2009 H1N1 Test Given to Focus Diagnostics

FDA Issues Another Emergency Use Authorization for Commercial H1N1 Flu Test to Quest Diagnostics� Focus Diagnostics

Focus Diagnostics provides the first commercial test for detecting the 2009 H1N1 influenza virus that the FDA has authorized for emergency use.

Focus Diagnostics receives NYSDOH exemption for Diagnostic Immunology and Serology testing services

Focus Diagnostics Launches Laboratory Test for Chikungunya Virus

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