ANAchoice Specific Antibody Cascading Reflex (ANCHCR)

Test Code

Quest Code

CPT Codes

ANA Multiplex with Reflex to 11 Antibody Cascade begins with an ANAchoice® Screen.

If the ANAchoice® Screen is positive, it will reflex the following five antibodies at an additional charge: dsDNA (CPT code(s): 86225), Sm/RNP (CPT code(s): 86235), RNP (CPT code(s): 86235), Sm (CPT code(s): 86235), and Chromatin (CPT code(s): 86235).
If any of those five antibodies are positive, the cascade stops and the results are reported.
If all five of those antibodies are negative, four additional antibodies will be reflexed at an additional charge: SSA (CPT code(s): 86235), SSB (CPT code(s): 86235), Scl-70 (CPT code(s): 86235), Jo-1 (CPT code(s): 86235).
If any of those four antibodies are positive, the cascade stops and the results are reported.
If all four of those antibodies are negative, the following two additional antibodies will be reflexed at an additional charge: Ribosomal P (CPT code(s): 83516) and Centromere B (CPT code(s): 86235).

The cascade stops upon the first positive antibody found in a group. It is possible that antibodies in subsequent groups are also positive, but will not be added or reported. Please contact your local Quest Diagnostics Laboratory if you are interested in adding this additional testing.

Preferred Specimen
1 mL serum in gold top tube

Minimum Volume
0.5 mL

Other Acceptable Specimens
Plain red top tube

Transport Container
Transport tube

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

Immunoassay (IA)

Setup Schedule
7:00 a.m.; released 5:00 p.m.
2:00 p.m.; released 8:00 p.m. Days and evenings 7 days a week

Report Available
3 days

Reference Range
ANAchoice® Screen Negative

Clinical Significance
The ANAchoice® Cascading Reflex provides physicians with a cost-effective and medically justified approach to evaluating a patient with suspected rheumatologic disease. Eleven antibodies associated with specific rheumatologic disease entities are analyzed and resulted in sequential tiers until positive findings are reported. The test is not intended for the work-up of autoimmune hepatitis or other non-rheumatologic diseases.

Performing Laboratory
Quest Diagnostics - South Region

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.