CPT® Code 86362

The CPT® Code 86362 refers to the testing for Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody using a cell-based immunofluorescence assay (CBA). This antibody is specifically associated with myelin oligodendrocyte glycoprotein antibody disease (MOGAD), which is classified as an idiopathic inflammatory demyelinating disease affecting the central nervous system (CNS). MOGAD is characterized by the presence of antibodies that target oligodendrocytes, the cells responsible for the formation of myelin in the CNS. The significance of this test lies in its ability to assist healthcare providers in diagnosing MOGAD and distinguishing it from other similar conditions such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). The MOG-IgG1 antibody is particularly notable because it can be present in a subset of NMOSD patients who do not have the AQP4 antibody, which is typically used to identify this disorder. The clinical presentations of MOGAD can overlap with those of NMOSD and MS, including symptoms such as optic neuritis and transverse myelitis. However, MOGAD is associated with distinct features, a different treatment response, and a generally better prognosis compared to these other demyelinating diseases. To perform the test, a venous blood sample is collected from the patient, and the serum is subjected to a cell-based indirect immunofluorescence assay (CBA). This method utilizes human embryonic kidney (HEK) cells that have been genetically modified to express green fluorescent protein (GFP)-tagged MOG-IgG1 as the antigen substrate. The patient’s serum is incubated with these modified cells, followed by the addition of a secondary anti-human IgG antibody that is conjugated with fluorescein isothiocyanate. After the labeling process, the cells undergo washing and are examined under a fluorescent microscope. The presence of MOG-IgG1 is determined by scoring the fluorescent signal, which provides a qualitative result. Additionally, titration studies may be conducted to ascertain the dilution factor at which the specific fluorescence can be identified, yielding a semi-quantitative result. This test can be performed alongside other separately reportable tests, particularly those for AQP4 antibodies, to further support the diagnostic process.