The Center is supported by the CDC and sponsored by the American Association of Neuropathologists.

Protocols / Cerebrospinal Fluid (CSF)

Cerebrospinal Fluid (CSF) Protocol:

  • The cerebrospinal fluid (CSF) should be obtained by lumbar puncture.  The first 2ml of CSF that flows from the tap should be discarded.  Collect 2-5ml of CSF, avoiding bloody tap.
  • The CSF should be frozen as quickly as possible (preferably within  20 minutes) and stored at -80°C freezer (or, lacking that, in a -20°C freezer) until shipment on dry ice.

Cerebrospinal Fluid (CSF) Shipment:

  • A recent re-evaluation of the recommendation to ship CSF specimens frozen with dry-ice showed shipment by Federal Express at ambient temperature caused an average loss of -50% for the 14-3-3 protein (range -32 to -91%) and -9% for tau.
  • It is essential to ship CSF specimens frozen with dry-ice in order to obtain reliable results.
Note: Please send fixed and frozen tissue samples in separate containers to avoid freezing of the fixed tissue, which can result in artifacts. See the Shipping Instructions for more information.

PLEASE NOTE POLICY CHANGES EFFECTIVE MAY 1ST, 2011:


The National Prion Disease Pathology Surveillance Center (NPDPSC) will be charging for testing on cerebrospinal fluid (CSF) effective May 1st, 2011.

The ICD9 Code is 046.19 and the CPT codes are 86317 and 84182. Both are required for each CSF specimen submitted. Total cost for testing is $70.88.

In addition to our Test Request Form, all senders of CSF will be required to also complete and submit our
Billing Requisition Form ONLY if the NPDPSC is to bill patient directly.

For Roster/Client Billing, send out labs only need to submit our Test Request Form if NPDPSC is to bill lab directly.

If you have any questions regarding these policy changes, please contact us at 216-368-0587.
For billing questions, please contact our billing department at 877-854-3904.