Test Overview
Test Methodology

Screen: Indirect immunofluorescence (IFA), HEp-2000 substrate. If positive reflex to multiplex immunobead and anti-ds-DNA (EIA) assays for both adult and pediatric patients along with tissue ANA for pediatric patients only where indicated.

Test Usage

Initial Screening test for wide variety of autoimmune diseases including SLE, scleroderma, mixed connective issue disease and others. HEp-2000 cell substrate indirect immunofluorescence pattern and titer will be reported on the positive screens.
A positive screen will reflex to an additional testing cascade which is designed to identify the specificity of antinuclear antibodies observed in the screening assay. See Test Methodology section.
A positive screen in a child with concordant clinical findings suggests the possibility of SLE or juvenile rheumatoid arthritis/juvenile chronic arthritis. A positive ANA HEp-2000 IFA screen will reflex to a tissue ANA in addition to the adult reflexive testing. See Test Methodology section.

Reference Range *

ANA Screen: Negative, Titer: <1:80. See test specific handbook entries for reflexed testing (ADNA and ENA10) reference ranges.

* Reference ranges may change over time. Please refer to the original patient report when evaluating results.

Test Details
Days Set Up
Monday - Friday
Analytic Time

24 - 48 hours

Soft Order Code
MiChart Code
ANA Screening Algorithm (IFA HEp-2000 Substrate reflex to ENA Sub-serology
Chemical Pathology
Specimen Requirements
Collection Instructions

Collect specimen in SST tube. Centrifuge, aliquot serum into a plastic vial and refrigerate.

Alternate Specimen
Red top tube
Normal Volume
2.5 mL serum
Minimum Volume
1.5 mL serum
Rejection Criteria
Fluid and plasma specimens are not acceptable for NAB testing.
Additional Information

Initial testing includes Antinuclear Antibody by IFA, HEp-2000 Substrate (NAB). If the screen is positive, the following reflex testing will be performed at an additional charge: Antinuclear Antibody Titer & Pattern (NABTP), Antinuclear Antibody by Multiplexed Immunoassay (ANA), and DNA Antibody, Double-Stranded (ADNA), and for patients less than 18 years of age Antinuclear Antibody, Tissue Substrate (NABT) if clinically indicated. If the ANA is positive, an Extractable Nuclear Antibody panel (ENA10) will be performed at an additional charge. If the NABT is positive, a titer (NABTG) will be performed at an additional charge. Due to the known incidence of false positive SCL-70 results by the multiplex immunoassay method in patients without characteristic scleroderma symptoms, specimens positive for SCL-70 will be sent to Esoterix Laboratories for more specific SCL-70 ELISA testing at an additional charge (LSCL). If the EIA test is positive, a second method will be performed for confirmation at an additional charge (LSCLR). By ordering this test the clinician acknowledges additional reflex testing will be performed and billed at a separate additional charge if indicated.

CPT Code
Fee Code
Reflex CPT
NABTP 86039, NABT 86038, ANA 86038, ADNA 86225, NABTG 86039, ENA10 86235 x9, RSCL 86235, RSCLR 86331.
Reflex Fee Code
NABTP 21937, NABT 21903, ANA 30950, ADNA OA003, NABTG 21936, ENA10 KA002, RSCL AA289, RSCRL AA371.
42254-3 NAB, 5048-4 NAB Titer, 8061-4 ANA, 32677-7 ADNA