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HelpTest Code LPF Lipid Panel
Specimen Requirements
Submit only 1 of the following specimens:
Plasma
Container/Tube: Green-top (heparin) gel tube
Specimen Volume: 1.5 mL of heparinized
plasma
Transport Temperature: Refrigerate
Collection Instructions: Fasting (12-14 hour)
is preferred but not required. Separate plasma from cells within 2
hours of draw. Forward promptly.
Note: 1. Medicare frequency limitations exist for this test in addition to diagnosis requirements. Click on link for list of medically necessary diagnoses: http://www.munsonhealthcare.org/medical-necessity. See Advance Beneficiary Notice of Noncoverage (ABN) form in Special Instructions.
2. Indicate plasma.
3. Label specimen appropriately (plasma).
Serum
Container/Tube: Gold-top serum gel tube
Specimen Volume: 1.5 mL of serum
Transport Temperature: Refrigerate
Collection Instructions: Fasting (12-14 hour)
is preferred but not required. Separate serum from cells within 2
hours of draw. Forward promptly.
Note: 1. Medicare frequency limitations exist for this test in addition to diagnosis requirements. Click on link for list of medically necessary diagnoses: http://www.munsonhealthcare.org/medical-necessity. See Advance Beneficiary Notice of Noncoverage (ABN) form in Special Instructions.
2. Indicate serum.
3. Label specimen appropriately (serum).
Performing Laboratory
Munson Healthcare Laboratories
Methodology
| Profile Information: | |
| Calculated LDL and VLDL | Cholesterol, Total |
| Cholesterol, HDL | Triglycerides |
Reference Values
The National Cholesterol Education Program (NCEP) has set the
following guidelines (reference values) for cholesterol, total:
If the patient is >19 years old, the following comments will
append to the results:
CHOLESTEROL, TOTAL
Desirable: <200 mg/dL
Borderline high: 200-239 mg/dL
High: ≥240 mg/dL
HDL, CHOLESTEROL
The National Cholesterol Education Program (NCEP) has set the following guidelines (reference values) for cholesterol, HDL:
Low: ≤39 mg/dL
Desirable: 40-59 mg/dL
High: ≥60 mg/dL
TRIGLYCERIDES
0-29 years: 10-140 mg/dL
30-39 years: 10-150 mg/dL
40-49 years: 10-160 mg/dL
50-125 years: 10-190 mg/dL
CALCULATED LDL
The National Cholesterol Education Program (NCEP) has set the following guidelines (reference values) for calculated LDL:
Optimal: <100 mg/dL
Optimal or above optimal: 100-129 mg/dL
Borderline high: 130-159 mg/dL
High: 160-190 mg/dL
Very high: >190 mg/dL
CALCULATED VLDL
The National Cholesterol Education Program (NCEP) guidelines do not address desirable levels of VLDL.
Day(s) Test Set Up
Monday through Sunday
Test Classification and CPT Coding
80061