Autoimmune disorder tests are designed to detect the presence of autoantibodies and other markers that indicate autoimmune activity in the body. Here are some common tests used to diagnose various autoimmune disorders:


Blood Tests for Autoimmune Disorders

Blood Tests for Autoimmune Disorders

Antinuclear Antibody (ANA) Test-CPT 86039Purpose:

Screens for autoantibodies that target substances within the nucleus of cells.
Associated Diseases: Systemic lupus erythematosus (SLE), Sjogren's syndrome, scleroderma, polymyositis, and mixed connective tissue disease (MCTD).

Anti-dsDNA and Anti-ssDNA Antibodies-CPT 86225Purpose: 

Detects antibodies against double-stranded and single-stranded DNA.

Associated Disease: SLE (highly specific for SLE, especially anti-dsDNA).

Anti-Smith (Sm) Antibodies-CPT 86235Purpose: 

Detects antibodies against Sm proteins.
Associated Disease: SLE (highly specific).

Anti-RNP (Ribonucleoprotein) Antibodies -CPT 86235Purpose: 

Detects antibodies against U1-snRNP.
Associated Diseases: MCTD, SLE.

Anti-SSA (Ro) and Anti-SSB (La) Antibodies CPT 86235 x 2Purpose: 

Detects antibodies against SSA/Ro and SSB/La proteins.
Associated Diseases: Sjogren's syndrome, SLE, neonatal lupus.

Anti-Jo-1 AntibodiesPurpose: 

Detects antibodies against the Jo-1 antigen.
Associated Disease: Polymyositis and dermatomyositis.

Anti-Scl-70 (Topoisomerase I) Antibodies -CPT 86235Purpose:

Detects antibodies against topoisomerase I.

Associated Disease: Scleroderma (especially diffuse systemic sclerosis).

Anti-Centromere Antibodies -CPT 83516Purpose: 

Detects antibodies against centromere proteins.
Associated Disease: CREST syndrome (a limited form of scleroderma).

Anti-Phospholipid AntibodiesPurpose: 

Detects antibodies against phospholipids.
Associated Diseases: Antiphospholipid syndrome, SLE (risk for blood clots, miscarriages).

Anti-Phospholipid Antibody testing involves a panel of tests rather than a single test, so there isn't a single CPT code for it. The specific CPT codes used will depend on the exact tests included in the panel ordered by your doctor. 

Here's a breakdown of the commonly included tests and their potential CPT codes:

Cardiolipin Antibodies (IgG and IgM):CPT code- 86140 (x2) 

This code indicates two separate tests performed, one for IgG and one for IgM antibodies.

Beta-2-Glycoprotein I Antibodies (IgG and IgM): CPT code - 86147 (x2)- 

Similar to the Cardiolipin test, this code signifies testing for IgG and IgM antibodies against Beta-2-Glycoprotein I.

Lupus Anticoagulant Evaluation: CPT code - Varies depending on the specific methods used. Some common codes include:

85613: This code is used for the dRVVT (diluted Russell viper venom time) test, a common method for Lupus Anticoagulant evaluation.
85598: This code might be used for the Hexagonal Phase I Phospholipid Neutralization test, a confirmatory test for Lupus Anticoagulant.

Rheumatoid Factor (RF) and Anti-Cyclic Citrullinated Peptide (Anti-CCP) AntibodiesPurpose: 

Detects rheumatoid factor and anti-CCP antibodies.
Associated Disease: Rheumatoid arthritis (anti-CCP is more specific).

Rheumatoid Factor (RF) and Anti-Cyclic Citrullinated Peptide (Anti-CCP) Antibodies typically have separate CPT codes since they are often performed as individual tests. Here's a breakdown:

Rheumatoid Factor (RF): The CPT code for RF testing depends on the specific method used by the laboratory. Here are two common possibilities:

86000: This code is used for RF testing by agglutination, a traditional method.
86001: This code is used for RF testing by immunoturbidimetric assay, a more automated method.

Anti-Cyclic Citrullinated Peptide (Anti-CCP) Antibodies: The CPT code for Anti-CCP testing is usually:

86185: This code applies to Anti-CCP antibody testing using enzyme-linked immunosorbent assay (ELISA), a common method.

Anti-Mitochondrial Antibodies (AMA)Purpose: Detects antibodies against mitochondrial antigens.

Associated Disease: Primary biliary cirrhosis (PBC).

The CPT code for Anti-Mitochondrial Antibodies (AMA) testing depends on the specific method used by the laboratory. Here are the two most common scenarios:

83516: This code applies to AMA testing using the indirect fluorescent antibody (IFA) method. This is the most common method used for AMA detection.

86381: This code is used by some labs for a more comprehensive AMA test that includes an AMA titer in addition to the initial screening. The AMA titer determines the level of antibodies present.

It's important to note that some laboratories might have their own unique codes for AMA testing variations. Here's what you can do to determine the exact code used for your test:

Consult your doctor: They can provide the specific code used for your AMA test.
Check the laboratory test directory: Many labs have online directories listing their tests and corresponding CPT codes. You can search for "AMA test" and see the associated code.
Look at your laboratory bill: The CPT code might be included on your bill for the AMA test.

Anti-Liver/Kidney Microsomal (LKM) AntibodiesPurpose: 

Detects antibodies against liver and kidney microsomes.
Associated Disease: Autoimmune hepatitis.

Complement LevelsC3 and C4 Complement Levels -CPT 86160 (x2)Purpose: 

Measures levels of complement proteins C3 and C4.

Associated Diseases: Low levels can indicate SLE and other autoimmune conditions where complement consumption occurs.

Inflammatory Markers

Erythrocyte Sedimentation Rate (ESR) -CPT 85652Purpose: 

Measures the rate at which red blood cells settle in a test tube over a period of time.
Associated Diseases: Elevated in many autoimmune and inflammatory conditions.


C-Reactive Protein (CRP)Purpose: 

Measures the level of CRP, a protein that increases in response to inflammation.
Associated Diseases: Elevated in various autoimmune and inflammatory diseases.

The CPT code for C-Reactive Protein (CRP) testing depends on whether it's a high-sensitivity CRP (hsCRP) test or a regular CRP test:

Regular CRP: The CPT code for a regular CRP test is 86140. This test is used for general inflammation detection.


High-Sensitivity CRP (hsCRP): The CPT code for a high-sensitivity CRP test is 86141. This test is more specific for detecting low-grade inflammation, which can be a risk factor for cardiovascular disease.

Organ-Specific Tests

Thyroid Antibodies (e.g., Anti-TPO, Anti-Tg)Purpose: 

Detects antibodies against thyroid peroxidase (TPO) and thyroglobulin (Tg).
Associated Diseases: Hashimoto's thyroiditis, Graves' disease.

Individual Tests: If the tests for Anti-TPO and Anti-Tg antibodies were ordered and performed separately, you'll see two separate CPT codes on your bill:

Anti-TPO (Thyroid Peroxidase Antibodies): The CPT code for this test is usually 86220.

Anti-Tg (Thyroglobulin Antibodies): The CPT code for this test is typically 86221.

Thyroid Antibodies Panel: Many laboratories offer a combined panel test for both Anti-TPO and Anti-Tg antibodies. In this case, the CPT code will likely be:

86227: This code applies to the Thyroid Microsomal Antibody (TMA) and Thyroglobulin Antibody (TgAb) combination test. TMA is another term for Anti-TPO antibodies.


Glutamic Acid Decarboxylase (GAD) Antibodies -CPT86341Purpose: 

Detects antibodies against GAD.
Associated Disease: Type 1 diabetes.
Other Specialized Tests

Electromyography (EMG)Purpose: 

Assesses the electrical activity of muscles.
Associated Diseases: Myopathies, including polymyositis and dermatomyositis.

The number of extremities studied: Codes are assigned based on whether the EMG examines one or multiple limbs and the number of muscles evaluated within each limb.
Needle vs. Non-needle EMG: There are separate codes for EMG using needle electrodes inserted into muscles and non-needle techniques that record electrical activity from the surface of the skin.
Specific muscle groups: Codes exist for studying specific muscle groups, like the thoracic paraspinal muscles.

Here's a breakdown of some common EMG CPT codes:

Needle EMG:Limited EMG (less than 5 muscles per extremity): 95870 (one code per extremity)
Thoracic Paraspinal Muscles: 95869 (one code for both sides)
Non-needle EMG (NCS - Nerve Conduction Studies often performed with EMG):

-Add-on code for EMG with NCS: +95885 (up to 4 extremities) or +95886 (more than 4 extremities)


Skin BiopsyPurpose: 

Examines a sample of skin tissue.
Associated Diseases: Various autoimmune skin conditions, including cutaneous lupus, vasculitis, and dermatomyositis.

The CPT code for a skin biopsy depends on the specific technique used to extract the tissue sample. There are three main categories with corresponding code ranges:

Tangential Biopsy (Shave, Scoop, Saucerize, Curette): This category uses a blade or scraping tool to remove a superficial layer of skin. The CPT code for this type of biopsy is 11102 for the first lesion biopsied. If additional lesions are biopsied in the same encounter, there's an add-on code (e.g., +11103) per each additional lesion.

Punch Biopsy: This technique uses a circular instrument to remove a small core of skin tissue. The CPT code for this type of biopsy is 11104 for the first lesion. Similar to tangential biopsies, additional lesions biopsied within the same encounter will have separate add-on codes (e.g., +11105).

Incisional Biopsy: This method involves using a scalpel to remove a larger sample of skin tissue. The CPT code range for incisional biopsies is 11106 to 11107. The specific code within this range depends on the size and complexity of the biopsy performed. Unlike the previous categories, there are no separate add-on codes for additional incisional biopsies within the same encounter.

These tests help clinicians diagnose and monitor autoimmune diseases by identifying specific autoantibodies, inflammation levels, and organ involvement. Proper diagnosis often requires a combination of these tests along with clinical evaluation and patient history.