Lupus Panel 3 with ANA, IFA with Reflex to Titer and Pattern

Test Code

19881

CPT Codes
86038, 86225, 86235 (x5), 86160 (x2), 86162

Includes

ANA Screen, IFA, with Reflex to Titer and Pattern
DNA (ds) Antibody
Sjogren's Antibodies (SS-A, SS-B)
Sm Antibody
RNP Antibody
Chromatin (Nucleosomal) Antibody
Complement Component C3c and C4c
Complement, Total (CH50)

If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).

Preferred Specimen

1 mL serum collected in each of four separate tubes

Minimum Volume

0.5 mL serum collected in each of four separate tubes

Transport Temperature

Frozen

Specimen Stability

Room temperature: Unacceptable
Refrigerated: Unacceptable
Frozen: 21 days

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

Gross hemolysis • Lipemia • Received thawed • Microbial contamination may interfere • Grossly icteric

Methodology
See individual tests

Setup Schedule

See individual assays

Clinical Significance

This panel can be helpful in the diagnosis and management of systemic lupus erythematosus (SLE). The panel simultaneously tests for antinuclear antibodies (ANAs) with an immunofluorescence assay (IFA), performed on human epithelial type 2 (HEp-2) cells, as well as 6 specific autoantibodies associated with SLE and 3 biomarkers associated with disease activity. For specimens with positive ANA IFA results, reflex testing for ANA titer and pattern is performed.

The ANA testing has high sensitivity (97%) for SLE but limited specificity (34%) [1]. Anti-dsDNA and anti-Sm antibodies are less sensitive but more specific; tests for both antibodies are included in classification criteria for SLE [2]. Anti-chromatin antibodies have relatively high sensitivity and specificity. Although antibodies to SSA and SSB may also be seen in Sjogren Syndrome and anti-RNP is a marker of mixed connective tissue disease, these antibodies are also frequently present in SLE and may be helpful.

The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.

References
1. Petri M, et al. Arthritis Rheum. 2012;64(8):2677-2686.
2. Aringer M, et al. Ann Rheum Dis. 2019;78(9):1151-1159.

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.