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Official Description

Oligoclonal immune (oligoclonal bands)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Oligoclonal bands are specific protein fragments produced by plasma cells, which are a type of white blood cell responsible for producing antibodies. The presence of these bands in the cerebrospinal fluid (CSF) can indicate various neurological conditions. The test for oligoclonal bands requires the collection of two distinct specimens: CSF and blood. The CSF is obtained through a procedure known as a lumbar puncture, which involves inserting a needle into the lower back to access the spinal canal. Blood is collected through a standard venipuncture procedure, where a needle is inserted into a vein, typically in the arm. Once both specimens are collected, they are analyzed to determine the ratio of oligoclonal bands present in the CSF compared to those in the serum. An elevated ratio of bands in the CSF is significant and may suggest the presence of several neurological disorders, including multiple sclerosis, Lyme disease, Devic's disease, systemic lupus erythematosus, neurosarcoidosis, subacute sclerosing panencephalitis, subarachnoid hemorrhage, syphilis, primary central nervous system lymphoma, Sjogren's syndrome, and Guillain-Barre syndrome. The testing process utilizes qualitative isoelectric focusing and immunofixation techniques to accurately identify and quantify the oligoclonal bands in both specimen types.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The oligoclonal bands test is indicated for the evaluation of various neurological conditions. The following conditions may warrant the performance of this test:

  • Multiple Sclerosis - A chronic disease affecting the central nervous system, characterized by the degeneration of myelin sheaths around nerve fibers.
  • Lyme Disease - An infectious disease caused by the Borrelia bacteria, transmitted through tick bites, which can affect the nervous system.
  • Devic's Disease - Also known as neuromyelitis optica, this condition primarily affects the optic nerves and spinal cord.
  • Systemic Lupus Erythematosus - An autoimmune disease that can affect multiple organ systems, including the nervous system.
  • Neurosarcoidosis - A condition characterized by the formation of granulomas in the nervous system, often associated with systemic sarcoidosis.
  • Subacute Sclerosing Panencephalitis - A rare progressive neurological disorder that occurs as a complication of measles infection.
  • Subarachnoid Hemorrhage - Bleeding in the space surrounding the brain, which can lead to neurological complications.
  • Syphilis - A sexually transmitted infection that can affect the central nervous system in its later stages.
  • Primary Central Nervous System Lymphoma - A type of cancer that originates in the lymphatic system and affects the brain or spinal cord.
  • Sjogren's Syndrome - An autoimmune disorder characterized by dry eyes and mouth, which can also affect the nervous system.
  • Guillain-Barre Syndrome - A rare neurological disorder in which the body's immune system mistakenly attacks the peripheral nerves.

2. Procedure

The procedure for testing oligoclonal bands involves several critical steps to ensure accurate results. First, a lumbar puncture is performed to collect cerebrospinal fluid (CSF). This procedure requires the patient to be positioned appropriately, often lying on their side or sitting up, to facilitate access to the spinal canal. A sterile needle is then inserted into the lower back, and CSF is drawn into a collection tube. This step is crucial as it provides the fluid necessary for analysis. Concurrently, a blood sample is obtained through a venipuncture, where a needle is inserted into a vein, typically in the arm, to collect serum. Both specimens, CSF and serum, must be handled with care to prevent contamination and ensure the integrity of the samples. Once collected, the samples are sent to a laboratory where they undergo qualitative isoelectric focusing and immunofixation techniques. These methods allow for the separation and identification of oligoclonal bands in both the CSF and serum, enabling the calculation of the ratio of bands between the two specimens.

3. Post-Procedure

After the lumbar puncture and blood collection, patients may experience some mild discomfort or headache, which is a common side effect of the procedure. It is important for patients to rest and stay hydrated following the test. Monitoring for any signs of complications, such as infection or excessive bleeding at the puncture site, is also essential. The results of the oligoclonal bands test are typically available within a few days, and healthcare providers will discuss the findings with the patient, including any necessary follow-up actions based on the results.

Short Descr OLIGOCLONAL BANDS
Medium Descr OLIGOCLONAL IMMUNE
Long Descr Oligoclonal immune (oligoclonal bands)
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
CLIA Waived (QW) No
APC Status Indicator Conditionally packaged laboratory tests
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) T1H - Lab tests - other (non-Medicare fee schedule)
MUE 2
CCS Clinical Classification 233 - Laboratory - Chemistry and Hematology
90 Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number.
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
91 Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient.
Date
Action
Notes
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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Description
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