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94954: Ana Scr,ifa,w/refl Titer/pattern/mplx 11 Ab W/identra(r) Print View
ANA Screen, IFA IFA     
Rheumatoid Factor IMMUNOTURB    IU/mL 
CCP Antibody (IgG) ELISA    Units 
14-3-3 eta Protein ELISA    ng/mL 

1 Serum 4 (2) mL   Room Temperature - 4 Day(s)/Refrigerated - 7 Day(s)/Frozen - 21 Day(s)  

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 14-3-3n (eta) protein, one of the components of the IdentRA panel(R), 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 14-3-3n 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 Sjogren syndrome, scleroderma, and multiple sclerosis.

Allow blood to clot (10-15 minutes) at room temperature.
Centrifuge and separate from cells.
Setup Schedule

Reported (Analytical Time)
3 days

CPT Codes

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.

Reflex Criteria:
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 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.
Specimen Requirements: 4 mL (2 mL minimum) serum
Transport Temperature: Room temperature
Reject Criteria: Gross hemolysis; grossly lipemic; grossly icteric
Methodology: See individual assays

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