Lupus Panel 2 with ANA, IFA with Reflex to Titer and Pattern

Test Code

29839

CPT Codes
86038, 86225, 86235 (x5)

Includes

ANA Screen,IFA, with Reflex to Titer and Pattern
DNA (ds) Antibodies
Scleroderma Antibodies (SCL-70)
Sm and Sm/RNP Antibodies
Sjogren's Antibodies (SSA, SSB)

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

Preferred Specimen

5 mL serum

Minimum Volume

2 mL

Transport Temperature

Room temperature

Specimen Stability

Room temperature: 4 days
Refrigerated: 7 days
Frozen: 30 days

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

Gross hemolysis • Grossly lipemic • Grossly icteric

Methodology
Immunoassay (IA)

Setup Schedule

Set up: Mon-Sat; Report available: 1-3 days

Reference Range

See individual tests

Clinical Significance

This panel supports the evaluation of systemic lupus erythematosus (SLE) and related autoimmune diseases, such as mixed connective tissue disease, systemic sclerosis, and Sjogren syndrome. However, testing for subserologies in the absence of a positive antinuclear antibody (ANA) result and clinically suspected autoimmune disease is generally not recommended [1].

This panel simultaneously tests for ANAs with an immunofluorescence assay (IFA) and 6 specific autoantibodies associated rheumatic and related diseases. The ANA testing has high sensitivity (97%) for SLE but limited specificity (34%) [2]. Thus, a positive ANA test result does not exclude other autoimmune diseases with similar clinical features [3]. Testing for specific autoantibodies, as well as other biomarkers associated with these autoimmune diseases, in a panel may expedite the evaluation of SLE.

Although individuals with negative results on the ANA IFA usually also have negative results for specific ANAs, Jo-1 antibody may be detected in ANA IFA-negative patients with some types of myositis, and SSA antibody may be detected in some ANA IFA-negative patients with lupus or Sjogren syndrome [1].

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

References
1. Yazdany J, et al. Arthritis Care Res (Hoboken). 2013;65(3):329-339.
2. Petri M, et al. Arthritis Rheum. 2012;64(8):2677-2686.
3. Kavanaugh A, et al. Arch Pathol Lab Med. 2000;124(1):71-81.

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.