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Test Code LPPR1 LIPID PANEL

Performing Laboratory

NorDx Laboratories

Useful For

The evaluation of cardiovascular risk

LDL Direct will automatically be performed at an additional charge when triglycerides are greater than 400.

Clinical Significance

Acetaminophen concentrations at toxic levels and high doses of N-Acetylcysteine (NAC) used to treat acetaminophen intoxication can falsely lower the result of this test.
N-Acetylcysteine used as mucolytic will not influence the result of this test.

Method Name

Spectrophotometry (SP)

Reference Values

Interpretive Guidelines:

FASTING SPECIMENS:

Total Cholesterol

Desirable: <200 mg/dL

Borderline high: 200-239 mg/dL

High: ≥240 mg/dL

LDL-Cholesterol

Optimal: <100 mg/dL

Low Risk: 100-129 mg/dL

Borderline high: 130-159 mg/dL

High: 160-189 mg/dL

Very high: ≥190 mg/dL

HDL-Cholesterol

Low: <40 mg/dL

Normal: 40-60 mg/dL

Desirable: >60 mg/dL

Triglycerides

Optimal: <150 mg/dL

Non HDL Cholesterol (Total Cholesterol – HDL Cholesterol) 0-129 mg/dL

NONFASTING SPECIMENS:

Triglycerides: < 175 mg/dL
(Based on literature)

Days and Times Test Performed

Monday through Sunday

Analytic Time

1 Day

Available Stat

Profile Information

Individual Test Description

CHOLESTEROL / HDL RATIO
CHOLESTEROL, HIGH-DENSITY LIPOPROTEIN (HDL), SERUM
CHOLESTEROL, TOTAL, SERUM
LDL CHOLESTEROL, CALCULATION
NON HDL CALCULATION
TRIGLYCERIDES, SERUM

Specimen Type

Submit one of the following:

~ Plasma (Maine Medical Center Only)

~ Serum

Preferred Container

Plasma Separator Tube (PST) (Maine Medical Center Only)

Serum Separator Tube (SST)

Preferred Volume

Plasma: 1 mL (Plasma Separator Tube (PST)) (Maine Medical Center Only)

Serum: 1 mL (Serum Separator Tube (SST))

Minimum Volume

Plasma: 0.5 mL (Plasma Separator Tube (PST))

Serum: 0.5 mL (Serum Separator Tube (SST))

Specimen Collection and Handling

1. Spin specimen, separate from clot within 4 hours of draw and send refrigerated.

2. Patient must not consume any alcohol for 24 hours before specimen is collected.

Rejection Information

Specimens that are frozen, grossly lipemic or hemolyzed

Specimen Stability Information

Specimen Type: Plasma

Refrigerated: 7 Days

Must be spun/separated within: 2 Hours

Specimen Type: Serum

Refrigerated: 7 Days

Must be spun/separated within: 2 Hours

Add On Capable

Yes

Advance Beneficiary Notice Requirements

This test, when ordered on Medicare patients, is subject to the National Coverage Determination (NCD) policies. Please verify that the diagnosis code (ICD code) you have chosen demonstrates medical necessity for the test as documented in the physician’s patient record. The CMS web site is available to assist you with this verification. A properly executed Advance Beneficiary Notice (ABN) must be submitted with the specimen if medical necessity is not demonstrated by the ICD code chosen.

CPT Code Information

CPT Code

CPT Description

CPT Disclaimer

80061 Lipid Panel
83721 Lipoprotein, Direct Measurement, Low Density Cholesterol (LDL Cholesterol) if Indicated

Acceptable Alternative Container(s)

Red Top Tube

Keywords

CHOLESTEROL, HDL (HIGH-DENSITY LIPOPROTEIN)

CHOLESTEROL, LDL (LOW-DENSITY LIPOPROTEIN)

HDL (HIGH-DENSITY LIPOPROTEIN) CHOLESTEROL

HIGH-DENSITY CHOLESTEROL (HDC)

LDL (LOW-DENSITY LIPOPROTEIN) CHOLESTEROL

TRIGLYCERIDES

Performing Laboratory Location

NorDx Laboratories