Endomysial Antibody Screen (IgA) with Reflex to Titer

Cleveland HeartLab E, Test


CPT Code: 86231
Order Code: 15064
Note: If Endomysial Antibody (IgA) Screen is Positive, then Endomysial Antibody Titer will be performed at an additional charge (CPT code: 86231).

ABN Requirement:
Specimen: Serum
Volume:  1.0 mL
Minimum Volume:  0.3 mL
Container: Gel-barrier tube (SST)


  1. Collect and label sample according to standard protocols.
  2. Gently invert tube 5 times immediately after draw. Do not shake.
  3. Allow blood to clot 30 minutes.
  4. Centrifuge for 10 minutes.

Transport: Store serum at 2°C to 8°C after collection and ship the same day per packaging instructions included with the provided shipping box.


Ambient (15-25°C): 7 days
Refrigerated (2-8°C):
21 days
Frozen (-20°C):
21 days

Causes for Rejection: Specimens other than serum; improper labeling; samples not stored properly; samples older than stability limits; gross hemolysis; gross lipemia

Methodology: Immunofluorescence Assay (IFA)

Turn Around Time:  3 to 5 days

Reference Range:

Endomysial Antibody (IgA) Negative
Endomysial Antibody Titer <1.5


Clinical Significance: The presence of anti-endomysial (EMA) IgA antibodies has been shown to correlate with gluten-sensitive enteropathy such as celiac disease (CD) and dermatitis herpatiformis (DH). EMA is detected primarily by IFA using monkey esophagus as a substrate and observing fluorescence of the endomysial lining. Patients with CD and DH can also demonstrate antibodies to reticulin and gliadin, through EMA-IgA seems to be the most specific marker (specifically 94-100%).

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.