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Test Name

ANCA, C and P, by IFA with Reflex to Titer

CPT Code(s)



If ANCA screen is positive, C-ANCA and/or P-ANCA titers will be performed at an additional charge (CPT code(s): 86021 for each titer performed).


Immunofluorescent Assay (IFA)

Reference Range(s)

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

Clinical Significance

Testing for anti-neutrophil cytoplasmic antibody (P-ANCA and or C-ANCA) has been found to be useful in establishing the diagnosis of suspected vascular diseases (WG, crescentic glomerulonephritis, microscopic polyarteritis and Churg-Strauss syndrome), bowel disease (Crohn's disease, ulcerative colitis, primary sclerosing cholangitis, and autoimmune hepatitis) as well as with other autoimmune diseases (drug-induced lupus, SLE, Felty's syndrome). ANCA has classically been divided into C-ANCA and P-ANCA depending on the immunofluorescent pattern observed. More recently the specific antigens responsible for these patterns have been described and isolated. The antigen that gives the C-ANCA pattern is proteinase-3 (PR3). Multiple antigens are responsible for P-ANCA pattern, the principle antigen being myeloperoxidase (MPO). Patients with bowel disease have been shown to have antibodies that give a P-ANCA or C-ANCA pattern. These antibodies however may not be directed towards MPO. Patients with drug induced lupus, etc, often present with a P-ANCA pattern that is associated with antibodies against MPO.

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Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The CPT codes provided 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 payer being billed.

* The tests listed by specialist are a select group of tests offered. For a complete list of Quest Diagnostics tests, please refer to our Directory of Services.

ANCA, C and P, by IFA with Reflex to Titer