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Official Description

Antinuclear antibodies (ANA); titer

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 86039 refers to the laboratory test for Antinuclear Antibodies (ANA) titer, which is a specific blood test used to assess the presence and concentration of antinuclear antibodies in a patient's blood sample. Antinuclear antibodies are a type of auto-antibody that target the body's own cellular structures, particularly those within the nucleus of cells. The presence of these antibodies can be indicative of various autoimmune disorders that lead to inflammation of body tissues. Conditions such as systemic lupus erythematosus, Sjogren's syndrome, rheumatoid arthritis, polymyositis, scleroderma, Hashimoto's thyroiditis, juvenile diabetes mellitus, Addison disease, vitiligo, pernicious anemia, glomerulonephritis, and pulmonary fibrosis may be associated with elevated levels of antinuclear antibodies. The testing process typically begins with a screening test, designated by CPT® Code 86038, which employs an enzyme-linked immunosorbent assay (ELISA) to detect the presence of antinuclear antibodies. If the screening yields a positive result, indicating that antinuclear antibodies are present, the ANA titer (CPT® Code 86039) is then performed. This titer test involves diluting the blood sample with increasing concentrations of saline solution and retesting until the antibodies are no longer detectable. The results of the ANA titer are expressed in a ratio format, such as 1:10, 1:20, 1:40, or 1:80, where the first number represents one part of blood and the second number indicates the corresponding parts of saline solution. A higher second number signifies a greater concentration of antinuclear antibodies in the blood, providing valuable information for diagnosing and managing autoimmune conditions.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The Antinuclear Antibodies (ANA) titer test, represented by CPT® Code 86039, is indicated for the evaluation of various autoimmune disorders. The presence of antinuclear antibodies can suggest the following conditions:

  • Systemic lupus erythematosus A chronic autoimmune disease that can affect multiple organ systems.
  • Sjogren's syndrome An autoimmune disorder characterized by dry eyes and dry mouth due to the destruction of glands that produce moisture.
  • Rheumatoid arthritis A chronic inflammatory disorder affecting the joints, leading to pain and potential joint damage.
  • Polymyositis An inflammatory disease causing muscle weakness and inflammation.
  • Scleroderma A group of autoimmune diseases that cause the skin and connective tissues to harden and tighten.
  • Hashimoto's thyroiditis An autoimmune disorder that affects the thyroid gland, leading to hypothyroidism.
  • Juvenile diabetes mellitus An autoimmune condition that results in the destruction of insulin-producing cells in the pancreas.
  • Addison disease A disorder in which the adrenal glands do not produce sufficient hormones.
  • Vitiligo A condition that causes loss of skin color in patches due to the destruction of melanocytes.
  • Pernicious anemia An autoimmune condition that affects the absorption of vitamin B12, leading to anemia.
  • Glomerulonephritis An inflammation of the kidney's filtering units, which can be caused by autoimmune processes.
  • Pulmonary fibrosis A lung disease that occurs when lung tissue becomes damaged and scarred, potentially linked to autoimmune conditions.

2. Procedure

The procedure for obtaining an Antinuclear Antibodies (ANA) titer involves several key steps to ensure accurate results. Initially, a blood sample is collected from the patient, typically through venipuncture, where a needle is inserted into a vein to draw blood. This sample is then processed for the initial screening test, which is performed using the enzyme-linked immunosorbent assay (ELISA) method, as indicated by CPT® Code 86038. The ELISA test detects the presence of antinuclear antibodies in the blood. If the screening test returns a positive result, indicating that antinuclear antibodies are present, the next step is to perform the ANA titer test, represented by CPT® Code 86039. During the titer test, the blood sample is diluted with increasing amounts of saline solution. This dilution process continues until the antibodies are no longer detectable in the sample. The results of the titer are expressed in a ratio format, such as 1:10, 1:20, 1:40, or 1:80. In this notation, the first number represents one part of the blood sample, while the second number indicates the corresponding parts of saline solution used for dilution. A higher second number signifies a higher concentration of antinuclear antibodies in the blood, providing critical information for the diagnosis and management of potential autoimmune disorders.

3. Post-Procedure

After the completion of the Antinuclear Antibodies (ANA) titer test, there are generally no specific post-procedure care requirements for the patient. However, it is important for healthcare providers to monitor the patient for any potential adverse reactions related to the blood draw, such as bruising or discomfort at the puncture site. The results of the ANA titer test will be analyzed and interpreted by the healthcare provider, who will discuss the findings with the patient and determine any necessary follow-up actions or additional testing based on the results. The interpretation of the ANA titer results is crucial for diagnosing autoimmune conditions and guiding further management and treatment options.

Short Descr ANTINUCLEAR ANTIBODIES (ANA)
Medium Descr ANTINUCLEAR ANTIBODIES ANA TITER
Long Descr Antinuclear antibodies (ANA); titer
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
CLIA Waived (QW) No
APC Status Indicator Conditionally packaged laboratory tests
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) T1H - Lab tests - other (non-Medicare fee schedule)
MUE 1
CCS Clinical Classification 235 - Other Laboratory
90 Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number.
91 Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
SA Nurse practitioner rendering service in collaboration with a physician
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
1993-01-01 Added First appearance in code book in 1993.
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