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.