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Proper testing for Lyme with medicare

Messages
61
Hi All
Can anyone suggest which is the proper test to begin to rule out Lyme disease if one has medicare? The primary MD just wrote Lyme confirmatory test with cpt code 86617 with Labcorp. Is this enough? I keep reading that ELISA should be done with the western Blot. Which test number is this please? I was looking a Labcorp test menu and it just has Lyme disease IGM ..is this the Elisa test? Also there is a note at bottom of the western blot test sample that says:
"Sera from individuals with the following may cross react in the Lyme Western Blot assays: other spirochetal diseases (periodontal disease, leptospirosis, relapsing fever, yaws, and pinta); connective autoimmune (Rheumatoid Arthritis and Systemic Lupus Erythematosus and also individuals with Antinuclear Antibody); other infections (Rocky Mountain Spotted Fever; Epstein−Barr Virus, and Cytomegalovirus)."

Now my family member that I am trying to get this test for does have high EBV (>600) and Cytomeglovirus (10) IGG titers. So in this scenario, would it be advisable to do the western blot?
Any guidance is appreciated very much!
 

Thinktank

Senior Member
Messages
1,640
Location
Europe
It's better to do both. C6 ELISA IgM / IgG and the western blot.

These tests are still insufficient and often give a false negative result but there's nothing better on offer yet.
Tests like the LTT / Elispot from arminlabs and others are very unreliable giving too many false positives.

If the tests are negative and if an infectious disease specialist with vast knowledge of lyme disease (hard to find) has ruled out lyme disease by clinical investigation then in my opinion it's not worthwile to pursue it any further, don't fall into the "chronic lyme disease" trap unless it's clearly proven by investigation.
 
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Messages
61
So the MD only wrote a test for Western Blot only and it only showed that band 41 was positive. Can this be a definitive negative for Lyme? Supposedly 2 of the bands have to be positive to equate to a positive test?
Can anyone shed any light on this?
 

Ema

Senior Member
Messages
4,729
Location
Midwest USA
So the MD only wrote a test for Western Blot only and it only showed that band 41 was positive. Can this be a definitive negative for Lyme? Supposedly 2 of the bands have to be positive to equate to a positive test?
Can anyone shed any light on this?
The result is only as good as the testing procedure. I

f you are considering being treated for Lyme, with antibiotics, often for years, I would consider pursuing a test from one of the specialty labs.