Inflammatory Bowel Disease Differentiation Panel

Test Code

16503

CPT Codes
86021 (x2), 86036, 86671 (x2)

Includes

ANCA Screen with Reflex to ANCA Titer
Myeloperoxidase Antibody (MPO)
Proteinase-3 Antibody
Saccharomyces cerevisiae Antibodies (ASCA) (IgG)
Saccharomyces cerevisiae Antibodies (ASCA) (IgA)

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

2 mL serum

Minimum Volume

1.4 mL

Transport Container

Plastic screw-cap vial

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 7 days
Refrigerated: 14 days
Frozen: 21 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis • Grossly icteric • Lipemic

Methodology
Immunoassay (IA)

Setup Schedule

Set up: Mon-Sat; Report available: 3-5 days

Reference Range

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

Myeloperoxidase Antibody

<1.0 AI	No antibody detected
≥1.0 AI	Antibody detected

Proteinase-3 Antibody

<1.0 AI	No antibody detected
≥1.0 AI	Antibody detected

Saccharomyces cerevisiae Ab (IgG)

≤20.0 U	Negative
20.1-29.9 U	Equivocal
≥30.0 U	Positive

Saccharomyces cerevisiae Ab (IgA)

≤20.0 U	Negative
20.1-24.9 U	Equivocal
≥25.0 U	Positive

Clinical Significance

This panel is useful in the diagnosis of Inflammatory Bowel diseases and can help to distinguish patients with ulcerative colitis from those with Crohn's Disease.

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.