Lupus Panel 4 with ANA, IFA with Reflex to Titer and Pattern

Test Code

10716

CPT Codes
83516, 86038, 86160 (x2), 86225, 86235 (x5), 86376, 86431

Includes

ANA Screen, IFA with Reflex to Titer and Pattern
Complement Component C3c and C4c
DNA (ds) Antibody
Ribosomal P Antibody
Sm Antibody
Sm/RNP Antibody
Sjogren’s Antibodies (SS-A, SS-B)
Thyroid Peroxidase Antibody (TPO)
Scleroderma Antibody (Scl-70)
Rheumatoid Factor

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

Preferred Specimen

4 mL serum

Minimum Volume

2 mL

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Room temperature: Unacceptable
Refrigerated: 4 days
Frozen: 8 days

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

Gross hemolysis • Grossly lipemic • Grossly icteric

Methodology
Immunoassay (IA) • Immunoturbidimetric Assay

Setup Schedule

Set up: Mon-Fri; Report available: 1-4 days

Reference Range

See individual tests

Clinical Significance

This panel can be helpful in the diagnosis of systemic lupus erythematosus (SLE) and several other autoimmune diseases, including mixed connective tissue disease, Sjogren syndrome, systemic sclerosis, and autoimmune thyroid disease. The panel simultaneously tests for antinuclear antibodies (ANAs) with an immunofluorescence assay (IFA), performed on human epithelial type 2 (HEp-2) cells, and 11 biomarkers associated with these conditions. 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]. Thus, a positive ANA test does not exclude other autoimmune diseases with similar clinical features [2]. Testing for specific antibodies in a panel may expedite the evaluation of SLE but is generally not recommended [3].

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. Kavanaugh A, et al. Arch Pathol Lab Med. 2000;124(1):71-81.
3. Yazdany J, et al. Arthritis Care Res (Hoboken). 2013;65(3):329-339.

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.