Antinuclear antibody titer, measuring how dilute the sample can be while still showing ANA, typically done after a positive ANA screen.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 2 cited references ↓
- Positive ANA screen result
- Order for reflex titer or separate titer order
- Symptoms supporting autoimmune workup
- Lab report with titer and pattern
- Diagnosis consistent with suspected connective tissue disease
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 2 cited references ↓
The ANA titer, 86039, usually follows a positive screen (86038), either as a reflex the lab performs automatically or a separate order. The titer, along with the staining pattern, tells the rheumatologist how seriously to take the positive result. A low titer is common in healthy people. A high titer pushes toward lupus, Sjogren syndrome, or scleroderma.
For ortho practices, the titer shows up when the inflammatory arthritis workup was sent with "ANA with reflex to titer." The lab bills both codes when both were done. Make sure your own charge capture does not post a second titer charge if the lab bills you on a purchased basis.
If the screen is negative, no titer should be billed. A payer seeing 86039 without a positive 86038 on the same date, or the lab report showing a negative screen, will deny the titer.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
Common denial reasons
The recurring reasons claims for CPT 86039 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Titer billed after a negative screen
- No screen documented
- Duplicate titer posted by office and lab
- Diagnosis does not support autoimmune testing
- Repeat titer without clinical change
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01Is 86039 billed with 86038?
02What does an ANA reflex order mean for billing?
03Does the staining pattern have its own code?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/medicare/payment/fee-schedules/clinical-laboratory-fee-schedule-clfs
Mira Scribe
Mira Scribe documents the clinical picture behind an autoimmune workup, so a positive screen and its titer both trace to a clear reason.
See how Mira captures CPT 86039 documentation