ANA, IFA, Cascade and Rheumatoid Arthritis Panel 2, with Reflexes

ANA, IFA, Cascade and Rheumatoid Arthritis Panel 2, with Reflexes

Test Code

94954
83520, 86038, 86200, 86431
94954
83520, 86038, 86200, 86431
Not offered in Quest Diagnostics Nichols Institute (IFD) – San Juan Capistrano. Please provide SERVICE AREA INFORMATION to find available tests you can order.
In-home collection may be available in your area for purchase through Quest Mobile.

Clinical Significance

ANA, IFA, Cascade and Rheumatoid Arthritis Panel 2, with Reflexes - This test can be helpful in the diagnosis of autoimmune rheumatic diseases. Specimens with positive results for antinuclear antibodies (ANA) by indirect immunofluorescence assay (IFA) are subsequently tested for a series of ANA-specific autoantibodies in cascade tiers. The first tier focuses on autoantibodies associated with systemic lupus erythematosus (SLE) and mixed connective tissue disease; the second tier detects autoantibodies seen in Sjogren syndrome, systemic sclerosis and polymyositis; and the third tier includes markers of the limited form of systemic sclerosis and neuropsychiatric SLE. ...

Test Resources

Test FAQ

Tests for Autoimmune Diseases (ANA)

Algorithm

ANA, IFA, Cascade with Rheumatoid Arthritis Panel 2, with Reflexes (test code 94954).

Clinical Focus

Autoimmune Rheumatic and Related Diseases

Clinical Focus

Systemic Sclerosis: Laboratory Markers for Diagnosis and Prognosis

Test Summary

ANA, IFA, Cascade and Rheumatoid Arthritis Panel 2, With Reflexes

Test 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

Reference Range(s)

See Laboratory Report

Alternative Name(s)

Rheumatic disease,Early Rheumatoid Arthritis,Autoimmune Disorders,Early Autoimmune Disease,Antinuclear Antibody Screen

LOINC® Codes, Performing Laboratory

Service Area must be determined
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

Reference Range(s)

See Laboratory Report

Alternative Name(s)

Rheumatic disease,Early Rheumatoid Arthritis,Autoimmune Disorders,Early Autoimmune Disease,Antinuclear Antibody Screen
Service Area must be determined

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

Setup Schedule

Service Area must be determined
4 mL serum
2 mL
Allow blood to clot (10-15 minutes) at room temperature. Centrifuge and separate from cells.
Transport tube
Room temperature
Room temperature: 4 days
Refrigerated: 7 days
Frozen: 21 days
Gross hemolysis • Grossly lipemic • Grossly icteric
Service Area must be determined
Not offered in Quest Diagnostics Nichols Institute (IFD) – San Juan Capistrano. Please provide SERVICE AREA INFORMATION to find available tests you can order.
In-home collection may be available in your area for purchase through Quest Mobile.
Test Details

Clinical Significance

Test Resources

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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