The ACR’s Regional Advisory Council (RAC) has received several member reports of false results on antinuclear antibody (ANA) tests. The test screens for systemic lupus erythematosus, drug-induced lupus, and other diseases. Results are used to direct treatment, so accuracy is crucial.
RAC member John Goldman, MD, investigated the issue to help ACR members obtain accurate test results. Indirect Fluorescent Antibody (IFA) is the gold standard for ANA testing. Quest Diagnostics generally screens ANA tests with ELISA and, if the result is positive, reflexes to IFA. However, physicians can request an IFA by ordering 249X and adding “Force Reflex” to the order.
LabCorp screens ANA tests with Athena Beads. The Athena Bead test has different colored beads, each one coated with different ANA subsets: SSA, SSB, Sm, RNP, Scl-70, Jo-1, Centromere B, dsDNA, and Histone. The test is positive if any of the subsets are over 100. Physicians may request IFA by ordering 164947.
Dr. Goldman reviewed the literature and determined that Athena Beads and ELISA ANA testing are somewhat comparable, but neither is as reliable as IFA. The RAC wants to make sure ACR members have the information necessary to make appropriate decisions for their practices. If you have additional questions or concerns, contact ACR coding specialists Melesia Tillman, CPC, or Resaee Freeman, CPC, via e-mail at [email protected] or [email protected], respectively, or by phone at (404) 633-3777.