Test Overview
Test Methodology

Screen: Indirect immunofluorescence (IFA), HEp-2000 substrate. If positive reflex to multiplex immunobead and anti-ds-DNA (EIA) assays (and tissue ANA 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 Testing: adult algorithm
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 pediatric specific algorithm. See testing: pediatric algorithm

Reference Range *

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

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
Rejection Criteria
Fluid and plasma specimens are not acceptable for NAB testing.
Yellow Top Tube
Normal Volume
2.5 mL serum
Minimum Volume
1.5 mL serum
CPT Code
Fee Code
Reflex CPT
86039 NAB Titer, 86038 ANA, 86225 ADNA, 86235 (each antibody) ENA10, 86038 ANA Tissue (pediatric), 86039 ANA Tissue Titer (pediatric)
Reflex Fee Code
30914 NAB Titer, 30950 ANA, OA003 ADNA, KA002 ENA10, 21903 ANA Tissue (pediatric), 21936 ANA Tissue Titer (pediatric)
42254-3 NAB, 5048-4 NAB Titer, 8061-4 ANA, 33800-4 ADNA, Z1002-5, 16137-2, Z1001-7,31592-9 ENA10
NY State Approved