Ordering Recommendation

Highly specific serologic test to aid in the workup of suspected rheumatoid arthritis (RA) or undifferentiated inflammatory arthritides. Use of IgA and IgG antibodies against cyclic citrullinated peptide (CCP) enhances sensitivity for RA diagnosis. The preferred test for initial screening is Rheumatoid Arthritis (RA) Panel (3016634).

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Serum separator tube (SST).

Specimen Preparation

Separate serum from cells ASAP or within 2 hours of collection. Transfer 1.0 mL serum to an ARUP standard transport tube. (Min: 0.5mL)

Storage/Transport Temperature


Unacceptable Conditions

Contaminated, heat-inactivated, grossly hemolyzed, grossly icteric, or grossly lipemic specimens.


After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 30 days (avoid repeated freeze/thaw cycles)


Semi-Quantitative Enzyme-Linked Immunosorbent Assay (ELISA)




1-2 days

Reference Interval

Test Number
Reference Interval
  Cyclic Citrullinated Peptide Ab, IgG/A 19 Units or less

Interpretive Data

19 Units or less:           Negative
20-39 Units:                  Weak positive
40-59 Units:                  Moderate positive
60 Units or greater:     Strong positive

A positive result for cyclic citrullinated peptide (CCP) antibodies in conjunction with consistent clinical features may be suggestive of rheumatoid arthritis (RA). Anti-CCP, IgG/IgA antibodies are present in about 66-74 percent of RA patients and have specificities of 96-99 percent. Detection of IgA antibodies in addition to the usual IgG antibodies enhances the sensitivity due to some RA patient shaving IgA antibodies to CCP in the absence of IgG. These autoantibodies may be present in the preclinical phase of disease, are associated with future RA development, and may predict radiographic joint destruction. Patients with weak positive results should be monitored and testing repeated.

Compliance Category



Hotline History


CPT Codes



Component Test Code* Component Chart Name LOINC
3016633 Cyclic Citrullinated Peptide Ab, IgG/A 57093-7
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.


  • ACPA Antibody
  • Anti Citrullinated Antibody
  • Anti Citrulline
  • Anti-CCP
  • Anti-CCP Antibody
  • Anti-Citrullinated Ab
  • Anti-Citrullinated Antibody
  • Anti-Citrullinated Protein/Peptide Antibody (ACPA)
  • Anti-Citrulline Antibody
  • Anti-Cyclic Citrullinated Peptide
  • AntiCCP Antibody
  • Anticitrullinated Antibody
  • Anticitrullinated Protein/Peptide Antibody (ACPA)
  • Anticitrulline Antibody
  • Anticyclic Citrullinated Peptide (CCP) Antibody
  • CCP
  • CCP IgA
  • CCP IgG
  • CCP IgG/IgA
  • CCP3 Antibody
  • CCP3 IgA
  • CCP3 IgG
  • CCP3 IgG/IgA
  • CCP3.1
  • CCP3.1 Antibody
  • CCP3.1 IgA
  • CCP3.1 IgG
  • CCP3.1 IgG/IgA
  • Citrullinated Ab
  • Citrullinated Antibody
  • Citrullinated Protein/Peptide Antibody (ACPA)
  • Citrulline Antibody
  • Soft-CCP
Cyclic Citrullinated Peptide Antibody, IgG and IgA