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Test Name

ANA Screen,IFA,Reflex Titer/Pattern,Reflex Mplx 11 Ab Cascade with IdentRA®

To view specimen requirements and codes please Select a regional laboratory.

Not sure which laboratory serves your office? Call us 866-MYQUEST (866-697-8378)

CPT Code(s)**

86038, 86431, 86200, 83520
**IMPORTANT: CPT Code is informational only; obtain the Test Code for ordering.

Includes

ANA Screen,IFA, Reflex Titer/Pattern,and Reflex to Multiplex 11 Ab Cascade
Rheumatoid Factor
Cyclic Citrullinated Peptide (CCP) Antibody (IgG)
14-3-3 eta Protein*

The ANA Screen,IFA, Reflex Titer/Pattern,and Reflex to Multiplex 11 Ab Cascade begins with an ANA Screen, IFA.

If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge (CPT code(s): 86039).
Additionally, five antibodies will be performed 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 performed 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 performed at an additional charge: Ribosomal P (CPT code(s): 83516) and Centromere B (CPT code(s): 86235).

Please note the cascade stops upon the first positive antibody result(s) found in a group and an interpretive message is applied based on this information. It is possible that antibodies in subsequent groups are also positive, but will not be added, billed, or reported. Please contact your local Quest Diagnostics Laboratory if you are interested in adding this additional testing.

Methodology

See individual tests

Reference Range(s)

See Laboratory Report

Clinical Significance

This panel provides a broader tool for the diagnosis of comorbidities in autoimmune diseases including but not limited to systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), scleroderma, myositis, and mixed connective tissue disorder. Additionally it facilitates diagnosis of RA in ANA negative patients, a negative ANA result could be misleading to assume the absence of autoimmune disease and usually the urgency to diagnose or run additional testing lessens until symptoms return with full clinical disease. American College of Rheumatology (ACR) 2015 Guidelines recommend for early/subclinical diagnosis of RA before significant joint erosion occurs. The 14-3-3 (eta) protein, one of the components of the IdentRA® panel, is an emerging biomarker for diagnosis of early RA and erosive psoriatic arthritis. This protein in conjunction with rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody, is known to improve sensitivity for diagnosis of early and established RA. Blood levels of 14-3-3 appear to be elevated in patients with RA, but not in other diseases including psoriasis, osteoporosis, gout, ulcerative colitis, type 1 diabetes, SLE, Crohn disease, primary Sjögren syndrome, scleroderma, and multiple sclerosis.

Test FAQ

Frequently Asked Question(s); FAQ

Alternative Name(s)

Early Rheumatoid Arthritis,Early Autoimmune Disease,IdentRA®,Rheumatic disease,Autoimmune Disorders,Antinuclear Antibody Screen

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.

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ANA Screen,IFA,Reflex Titer/Pattern,Reflex Mplx 11 Ab Cascade with IdentRA®
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