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26526 Lyme Immunoassay, IgM and IgG

Lyme Immunoassay, IgM and IgG
Test Code: LYMG
Synonyms/Keywords

​​​Lyme confirmation, Lyme IgM, Lyme IgG, B. burgdorferi

Test Components

​Ig​M and IgG-class antibodies to B. burgdorferi (Lyme disease)

Useful For

​Confirmation of Lyme serology positive and equivocal results.

Specimen Requirements
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen 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
Collection Processing Instructions

​Separate serum from cells within 2 hours of collection​

Acceptable Specimen Types

​Serum

Specimen Stability Information
Specimen TypeTemperatureTime

​Serum
​​

​Refrigerated
​7 days
​Frozen (-20 oC)
3 months
Rejection Criteria

Turbid sera, gross hemolysis, gross lipemia or bacterially contaminated samples

Performing Laboratory Information

Performing LocationDay(s) Test PerformedAnalytical TimeMethodology/Instrumentation

​Marshfield
​Monday through Friday
​1 day
​Chemiluminescence immunoassay (Liaison XL)
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.

Reference Range Information
Performing LocationReference Range
​Marshfield
​Negative
Interpretation

Table: Guidance for the Interpretation of Lyme Disease (LD) MTTT Results


​​Test Sequence​

​​Interpretation for Providers
​ ​​
​Lyme Screen
Confirmatory Lyme IgMConfirmatory 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 (< or = 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 (< or = 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 (< or = 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 ( < or =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
Outreach CPTs
CPTModifier
(if needed)
QuantityDescriptionComments

​86617


​2
​Lyme Confirmatory Immunoassay, IgM and IgG
Synonyms/Keywords

​​​Lyme confirmation, Lyme IgM, Lyme IgG, B. burgdorferi

Test Components

​Ig​M and IgG-class antibodies to B. burgdorferi (Lyme disease)

Ordering Applications
Ordering ApplicationDescription
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen 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
Collection Processing

​Separate serum from cells within 2 hours of collection​

Acceptable Specimen Types

​Serum

Specimen Stability Information
Specimen TypeTemperatureTime

​Serum
​​

​Refrigerated
​7 days
​Frozen (-20 oC)
3 months
Rejection Criteria

Turbid sera, gross hemolysis, gross lipemia or bacterially contaminated samples

Useful For

​Confirmation of Lyme serology positive and equivocal results.

Test Components

​Ig​M and IgG-class antibodies to B. burgdorferi (Lyme disease)

Reference Range Information
Performing LocationReference Range
​Marshfield
​Negative
Interpretation

Table: Guidance for the Interpretation of Lyme Disease (LD) MTTT Results


​​Test Sequence​

​​Interpretation for Providers
​ ​​
​Lyme Screen
Confirmatory Lyme IgMConfirmatory 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 (< or = 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 (< or = 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 (< or = 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 ( < or =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
For more information visit:
Performing Laboratory Information

Performing LocationDay(s) Test PerformedAnalytical TimeMethodology/Instrumentation

​Marshfield
​Monday through Friday
​1 day
​Chemiluminescence immunoassay (Liaison XL)
For billing questions, see Contacts
Outreach CPTs
CPTModifier
(if needed)
QuantityDescriptionComments

​86617


​2
​Lyme Confirmatory Immunoassay, IgM and IgG
For most current information refer to the Marshfield Laboratory online reference manual.