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Lipid Panel

Additional Codes

LAB18

Performing Laboratory

MBMC Main Laboratory

Methodology

Method Name:
See individual test listings.

Testing Algorithm

If Triglyceride >400 mg/dL, then LDL Direct will be performed at an additional charge.

Specimen Requirements

Specimen Type: Plasma

Container/Tube: Mint-green top (lithium heparin gel)
Specimen Volume: Full tube

Collection Instructions: Fasting (12 hours)

Alternative Specimen Type: Serum

Alternative Container/Tube: Gold, Serum gel

Alternative Specimen Volume: Full tube

Specimen Transport Temperature

Ambient

Day(s) Test Set Up

Monday through Sunday
Turnaround Time:
STAT: 1 hour after receipt in laboratory
Routine: within 4 hours

Reference Values

Cholesterol

0 minutes-19 years   none-199 mg/dL

19 years - 150 years   30- 199 mg/dL

Ages ≤ 19 years

  Acceptable:        <170 mg/dL

  Borderline high:  170-199 mg/dL

  High:                   >or= 200 mg/dL

Ages ≥ 20 years

  Desirable:          <200 mg/dL

  Borderline high:  200-239 mg/dL

  High:                  >or= 240 mg/dL

 

Triglyceride

0 minutes-10 years    0-99 mg/dL

10 years-20 years      0-129  mg/dL

20 years-150 years    0-149 mg/dL

Ages ≤ 9 years

  Acceptable:       <75 mg/dL

  Borderline high:  75-99 mg/dL

  High:                  >or= 100 mg/dL

Ages 10 to 20 years

  Acceptable:       <90 mg/dL

  Borderline high:  90-129 mg/dL

  High:                  >or= 130 mg/dL

Ages ≥ 20 years

  Desirable:           <150 mg/dL

  Borderline high:  150-199 mg/dL

  High:                   200-499 mg/dL  

  Very high:           >or= 499 mg/dL

 

 

HDL Cholesterol

0 years-20 years        >45 mg/dL

20 years - 150 years  > 40 mg/dL

 

Ages ≤ 19 years

  Acceptable:       >45 mg/dL

  Borderline low:   40-45 mg/dL

  Low:                   <40 mg/dL

Ages ≥ 20 years

  Desirable:        >or= 60 mg/dL

  Low:                <40 mg/dL

 

Non-HDL Cholesterol

Ages ≤ 19 years

  Acceptable:         <120 mg/dL

  Borderline high:   120-144 mg/dL

  High:                    >145 mg/dL

Ages ≥ 20 years

  When triglycerides are >200 mg/dL, Non-HDL cholesterol is a secondary target of therapy with treatment goals that are 30 mg/dL greater than the LDL cholesterol target.    

 

LDL Cholesterol, calculated or direct

  0-129 mg/dL

 

Ages ≤ 19 years

  Acceptable:        <110 mg/dL

  Borderline high:  110-129 mg/dL

  High:                   >or= 160 mg/dL

Ages ≥ 20 years

  Optimal:               <100 mg/dL

  Near optimal:       100-129 mg/dL

  Borderline high:   130-159 mg/dL

  High:                    >160 mg/dL

 

Literature References:

1.     Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents. Pediatrics 2011;128:S213

2.     NCEP Expert Panel. Circulation 2004;110:227

Current Interpretive Data was last revised on 08/21/2018.

Test Classification and CPT Coding

 

Test Classification:This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer’s instructions.
CPT Code:
80061

 

83721 (if appropriate)

 

Profile Information

Cholesterol

LDL (Calculated)

Triglyceride

Cholesterol_HDL Ratio (Calculated)

High-Density Lipoprotein (HDL)

 

 

General Information:

See Common Panel Test Combinations in Special Instructions to avoid duplicate test requests when multiple panels are ordered.

Special Instructions