ANA, IFA, Cascade and Rheumatoid Arthritis Panel 2, with Reflexes
Test code
CPT code(s)*
Clinical significance
Test resources
Test FAQ
Details
Includes
ANA Screen,IFA, Reflex Titer/Pattern,and Reflex to Multiplex 11 Ab Cascade
Rheumatoid Factor
Cyclic Citrullinated Peptide (CCP) Antibody (IgG)
Mutated Citrullinated Vimentin (MCV) Antibody
The ANA, IFA, Cascade and Rheumatoid Arthritis Panel 2, with Reflexes begins with an ANA Screen, IFA.
If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).
Additionally, five antibodies will be performed at an additional charge: dsDNA (CPT code(s): 86225), Sm/RNP (CPT code(s): 86235), RNP (CPT code(s): 86235), Sm (CPT code(s): 86235), and Chromatin (CPT code(s): 86235).
If any of those five antibodies are positive, the cascade stops and the results are reported. If all five of those antibodies are negative, four additional antibodies will be performed at an additional charge: SSA (CPT code(s): 86235), SSB (CPT code(s): 86235), Scl-70 (CPT code(s): 86235), Jo-1 (CPT code(s): 86235).
If any of those four antibodies are positive, the cascade stops and the results are reported. If all four of those antibodies are negative, the following two additional antibodies will be performed at an additional charge: Ribosomal P (CPT code(s): 83516) and Centromere B (CPT code(s): 86235).
Please note the cascade stops upon the first positive antibody result(s) found in a group and an interpretive message is applied based on this information. It is possible that antibodies in subsequent groups are also positive, but will not be added, billed, or reported. Please contact your local Quest Diagnostics Laboratory if you are interested in adding this additional testing.
Methodology
Enzyme Linked Immunosorbent Assay (ELISA) • Immunofluorescence Assay (IFA) • Immunoturbidimetric
Alternative name(s)
Rheumatic disease,Early Rheumatoid Arthritis,Autoimmune Disorders,Early Autoimmune Disease,Antinuclear Antibody Screen
Specimen requirements | |
|---|---|
| Patient preparation | None Specified |
| Preferred specimen(s) | 4 mL serum |
| Minimum volume | 2 mL |
| Collection instructions | Allow blood to clot (10-15 minutes) at room temperature. Centrifuge and separate from cells. |
| Transport container | Transport tube |
| Transport temperature | Room temperature |
| Specimen stability | Room temperature: 4 days Refrigerated: 7 days Frozen: 21 days |
| Reject criteria | Gross hemolysis • Grossly lipemic • Grossly icteric |
Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.
*The CPT codes provided are based on AMA guidance and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
This material contains content from LOINC® (http://loinc.org). The LOINC Table, LOINC Table Core are copyright © 1995-2019, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license.
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