Test results question.

So my daughter's test results came back a few days ago and the llmd called to say she is positive with having bands 39 and 41 that were reactive. We are treating so that is not the issue. The question I have is that looking at the lab report in says CDC negative for igm and igg. I thought that if 2 of bands 23-25, 39, and 41 were positive than you have a positive igm test? Or did I not read that correctly?
It is kind of a big deal for us because without a CDC positive result I can not go back to the insurance company to see about paying for the visit. With all 4 kids and myself being treated for Lyme's it gets a little pricey paying out of pocket.

Thanks
Nick

Post Edited (nberg) : 7/14/2016 6:59:09 AM (GMT-6)

So is it 2 seperate sets of bands or is it 2 sets of criteria for the same bands? I am probably confused. I thought they just had 2 sets of criteria for the set of bands they use.

Agree with the other posts---

but it's good to understand the CDC's intentions behind this criteria, which can help you articulate a request to your insurance company for their coverage...

CDC Surveillnace Case Definition
The #s of bands and groups of bands required for IgM and IgG positivity in order to be "CDC positive" are based on the CDC's surveillance case definition criteria, which is intentionally very restrictive in order to control overreporting of Lyme disease. Remember that the CDC's main function is to monitor trends in diseases, not to govern health care decisions. So, from a CDC perspective, they are concerned about lyme from an epidemiological standpoint and overreporting lyme may be even more damaging to epidemiological assessments that help them understand trends in lyme.

"One of the greatest obstacles to surveillance is ensuring that the data collected represent the disease under consideration. Blended data arise when a single common diagnosis is used to identify multiple related diseases caused by distinct pathogens. This process ultimately creates epidemiological havoc by producing incorrect distributions, hospitalization rates, and case-fatality rates, based erroneously on amalgamated characteristics of several individual diseases." ---Excerpt from Institute of Medicine of the National Academies Lyme Workshop Report Paper: A1 THROUGH A GLASS, DARKLY: THE GLOBAL INCIDENCE OF TICK-BORNE DISEASES
Christopher D. Paddock, M.D., M.P.H.T.M., and Sam R. Telford III, Sc.D., Infectious Diseases Pathology Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, Division of Infectious Diseases, Department of Biomedical Sciences, Tufts University Cummings School of Veterinary Medicine; Corresponding author: Christopher D. Paddock, Infectious Diseases Pathology Branch, Bldg 18, Rm. SB 109, Mailstop G-32, Centers for Disease Control and Prevention
(sorry for the ridiculously long citation)

HOWEVER, the CDC also states VERY CLEARLY on their website that this criteria (the #s and groups of bands) should not be used for diagnosis nor treatment decisions. Those working for the CDC have also made this clarification very publicly - I can cite quotes if you like. The IDSA ignores this surveillance purpose and also bases their treatment protocols on this criteria.

Your insurance company should NOT be making coverage decisions based on the CDC's surveillance criteria.

Hope this is helpful -

-p