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LPPR1
LIPID PANEL

Test Code LPPR1 
Test LIPID PANEL 
Methodology Spectrophotometry 
Description Cholesterol, Total
HDL Cholesterol
LDL Cholesterol, Calculated
Triglycerides

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

NOTE: 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.

NOTE: This test, when ordered on Medicare patients, is subject to the National Coverage Determination (NCD) policy "Lipids Testing". Please verify that the diagnosis code (ICD-9) you have chosen demonstrates medical necessity for the test as documented in the physician's patient record. The CMS web site or the NorDx Limited Coverage Documentation Guide are 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-9 code chosen. 

Specimen Draw blood in either a plain, red-top tube or serum gel tube. (FROZEN, GROSSLY LIPEMIC, OR HEMOLYZED SPECIMEN IS NOT ACCEPTABLE.) Patient must not consume any alcohol for 24 hours before specimen is drawn. Spin down, separate serum from cells within 4 hours of draw, and send 1.0 mL (0.5 mL minimum) of serum refrigerated. 
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


NONFASTING SPECIMENS

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

Analytic Time 1 Day 
Day(s) Test Set Up Monday through Sunday 
CPT Code(s) 80061  
83721  LDL Direct (if appropriate)