ANCA Screen with Reflex to ANCA Titer

Test Code
70171


CPT Codes
86036

Includes
If ANCA Screen is positive, then C-ANCA Titer and/or P-ANCA Titer, and/or atypical P-ANCA Titer will be performed at an additional charge (CPT code(s): 86037 for each titer performed).


Preferred Specimen
1 mL serum


Minimum Volume
0.5 mL


Transport Container
Plastic screw-cap vial


Transport Temperature
Room temperature


Specimen Stability
Room temperature: 7 days
Refrigerated: 14 days
Frozen: 30 days


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Grossly lipemic


Methodology
Immunoassay (IA)

Setup Schedule
Set up: Mon-Sat p.m.; Report available: 3-5 days


Reference Range
ANCA Screen Negative
  C-ANCA Titer <1:20
  P-ANCA Titer <1:20
  Atypical P-ANCA Titer <1:20


Clinical Significance
Testing for anti-neutrophil cytoplasmic antibodies (P-ANCA and or C-ANCA) has been found to be useful in establishing the diagnosis of suspected vascular diseases (e.g., crescentic glomerulonephritis, microscopic polyarteritis and churg-strauss syndrome), bowel disease (Crohn's Disease, ulcerative colitis, primary sclerosing cholangitis, and autoimmune hepatitis) as well as with other autoimmune diseases (drug-induced lupus, SLE, Felty's Syndrome).
ANCA has classically been divided into C-ANCA and P-ANCA depending on the immunofluorescent pattern observed. More recently the specific antigens responsible for these patterns have been described and isolated. The antigen that gives the C-ANCA pattern is Proteinase-3 (PR-3). Multiple antigens are responsible for P-ANCA pattern, the principle antigen being Myeloperoxidase (MPO).
Patients with bowel disease have been shown to have antibodies that give a P-ANCA or C-ANCA pattern. These antibodies however may not be directed towards MPO. Patients with drug induced lupus, etc, often present with a P-ANCA pattern that is associated with antibodies against MPO.


Performing Laboratory
Quest Diagnostics Nichols Institute
14225 Newbrook Drive
Chantilly, VA 20153




The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.