Lupus Panel

Last Modified: 7/15/2019 4:31:51 PM


Medical Necessity Documentation:  
Client Notes:  
Patient Preparation:  
Specimen Requirements:

6.0 mL Serum in an SST Gold Top Tube

Collection Instructions:  
Minimum Volume: 4.0 mL
Transport & Storage: Temperature/Stability: 8 hrs Ambient
2 days Refrigerated
28 days Frozen

Do not transport Frozen.

Specimen to be transported Refrigerated to PRMC within 48 hours of collection to be frozen by Immunology department to maintain specimen integrity until testing occurs.
Rejection Criteria: Gross Hemolysis; Grossly lipemic; microbial contamination may interfere
Reference Range: Refer to Interpretive Results
Critical Ranges:  
Test Comments:

If ANA Screen is positive ANA pattern and Titer will be performed and charged.

Methodology: Multiple
Clinical Significance:  
Documentation:  
Custom Panel: No

PRODUCTION SCHEDULE

Turn Around Time: 6 to 10 days
Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Parkview Regional Medical Center, Quest - Chantilly
PHL Test Code: LUP
EPIC Test Code: IMO100
Alternate Test Names: Comprehensive Lupus Panel; Extended ANA; SLE
Included Tests: ANA with International Units and Pattern; Complement C3; Complement C4;DNA Antibody; Mitochondrial (M2) IgG Autoabs; Parietal Cell Total Autoantibodies; Rheumatoid Factor; Scl-70 IgG Autoantibodies; SM (Smith) IgG Autoantibodies; Smooth Muscle Total Autoantibodies; SS-A and SS-B IgG Autoantibodies; Striational Total Autoantibodies; Thyroid Peroxidase Autoantibodies; U1RNP/snRNP IgG Autoantibodies
CPT Coding: 86038 (Reflex 86039), 86160 x 2, 86225, 86235 x 5, 83516, 86255 x 2, 86376, 86430 (Reflex 86431), 83520

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