vovathreads.blogg.se - Western blot test lyme disease

The CDC (1995) states that when Western immunoblot is used during the first 4 weeks of disease onset (early LD), both immunoglobulin M (IgM) and immunoglobulin G (IgG) procedures should be performed. All specimens positive or equivocal by a sensitive EIA or IFA should be tested by a standardized Western immunoblot. The member has objective evidence of either relapse of infection, progression of Lyme disease organ damage, and/or the finding of a new focus or type of organ damage.įootnote1* Note: According to the CDC (1995), the recommended method for serologic detection of active disease or previous infection involves a 2-test approach using a sensitive enzyme immunoassay (EIA) or IFA followed by a Western immunoblot.The member has completed an initial course of appropriate intravenous antibiotic therapy and.The member has met the criteria for an initial course of intravenous antibiotic therapy, using lab results obtained within the past 3 months and.Stage III late Lyme disease documented by findings of arthritis and/or neurologic complications, such as encephalomyelitis and subacute encephalitis Īetna considers one repeat 4-week course of outpatient IV antibiotic therapy medically necessary when the member meets all of the following criteria:.Stage II Lyme disease with early dissemination documented by organ-specific manifestations of infection (arthritic, cardiac, or neurologic).Sensory/motor radiculoneuropathy or peripheral neuropathy (weakness and/or pain in the extremities or chest) Īll cases of Lyme disease in pregnant women who exhibit symptoms and signs of any of the following:.

Meningitis confirmed by CSF analysis showing a lymphocytic pleocytosis with evidence of antibody production against Borrelia burgdorferi in the CSF.Neurologic involvement of Lyme disease (neuroborreliosis) as evidenced by any of the following: Second- or higher degree atrio-ventricular block.A first-degree heart block with P-R interval greater than 0.4 seconds.Moderate-to-severe cardiac involvement as evidenced by any of the following:.

Lyme arthritis that persists after failing to respond to a 4-week course of appropriate oral antibiotic therapy.

This Clinical Policy Bulletin addresses lyme disease and other tick-borne diseases.Īetna considers outpatient intravenous (IV) antibiotic therapy medically necessary in adult and pediatric members with the diagnosis of Lyme disease only when it is based on the clinical presentation of signs and symptoms compatible with the disease and supported by a positive serologic and/or cerebrospinal fluid (CSF) titer by indirect immunofluorescence assay (IFA), Prevue Borrelia burgdorferi antibody detection assay, or enzyme-linked immunosorbent assay (ELISA), which itself is validated by a positive Western Blot Test (see CDC criteria in Footnote1*Note below).Once a definitive diagnosis of Lyme disease is established, Aetna considers an initial 4-week course of outpatient IV antibiotic therapy medically necessary when any of the following conditions is met: Number: 0215 Table Of Contents Policy Applicable CPT / HCPCS / ICD-10 Codes Background References