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ANA Scr,IFA w/Refl Titer/Pattern/MPX Ab Cascade
Test Code902092
CPT Codes
86038<br /> Limited Access Code
Includes
The ANA IFA with reflex to titer/pattern/Cascade begins with an ANA (Anti-Nuclear Antibody) IFA Screen.
If the ANA, IFA screen is positive, then the ANA, Titer & Pattern will be performed at an additional charge (CPT code:
86039). Additionally, five antibodies will be performed at an additional charge: dsDNA (CPT: 86225), Sm/RNP (CPT: 86235), RNP (CPT: 86235), Sm (CPT: 86235), and Chromatin (CPT: 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: 86235), SSB (CPT: 86235), Scl-70 (CPT: 86235), Jo-1 (CPT: 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: 83516) and Centromere B (CPT: 86038).
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.
If the ANA, IFA screen is positive, then the ANA, Titer & Pattern will be performed at an additional charge (CPT code:
86039). Additionally, five antibodies will be performed at an additional charge: dsDNA (CPT: 86225), Sm/RNP (CPT: 86235), RNP (CPT: 86235), Sm (CPT: 86235), and Chromatin (CPT: 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: 86235), SSB (CPT: 86235), Scl-70 (CPT: 86235), Jo-1 (CPT: 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: 83516) and Centromere B (CPT: 86038).
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.
Preferred Specimen
1 mL serum
Minimum Volume
0.2 mL
Transport Temperature
Room temperature
Specimen Stability
Room temperature: 4 days
Refrigerated: 7 days
Frozen: 30 days
Refrigerated: 7 days
Frozen: 30 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Grossly lipemic • Microbial contamination may interfere • Grossly icteric
Methodology
Immunofluorescence Assay
Setup Schedule
Set up: Daily; Report available: 1-2 days
Reference Range
See Laboratory Report
Clinical Significance
Antinuclear antibodies are present in Systemic Lupus Erythematosus, Sjogren's Syndrome, Mixed Connective Tissue Disease, Scleroderma, liver disease, Drug Induced Lupus, Rheumatoid Arthritis, and other autoimmune diseases.
