Lipoprotein Fractionation, NMR with Lipids

Cleveland HeartLab L, N, Test

NEW YORK DOH APPROVED: NO

CPT Code: 83704, 80061
Order Code: 37849
Includes: LDL Particle Number (LDL-P), Small LDL Particle Number (Small LDL-P), LDL Size, HDL Particle Number (HDL-P), Large HDL Particle Number (Large HDL-P), HDL Size, Large VLDL Particle Number (Large VLDL-P), VLDL Size, Total Cholesterol, HDL Cholesterol, Triglycerides, Calculated LDL Cholesterol, Cholesterol/HDL-C, Non-HDL Cholesterol, TG/HDL-C
ABN Requirement:
No
Specimen: Serum
Volume:  4.0 mL
Minimum Volume:  2.0 mL
Container: Red Top (no gel barrier) tube

Collection:

  1. Collect and label sample according to standard protocols.
  2. Gently invert tube 5 times immediately after draw. DO NOT SHAKE.
  3. Allow blood to clot 30 minutes.
  4. Centrifuge for 10 minutes.
  5. Aliquot serum into a labeled transport tube and cap tightly.

Fasting: Patient should be fasting 12 hours.

Transport: Store serum at 2°C to 8°C after collection and ship the same day per packaging instructions included with the provided shipping box.

Stability:

Ambient (15-25°C): Unacceptable
Refrigerated (2-8°C):
7 days
Frozen (-20°C):
10 days

Causes for Rejection: Specimens other than serum; improper labeling; samples not stored properly; samples older than stability limits; gross hemolysis; gross lipemia; serum collected using a gel barrier tube

Methodology: Nuclear Magnetic Resonance (NMR), Photometric, Calculations

Turn Around Time:  2 days

Relative Risk Range:

TestReference Range

Low
Relative Risk Range

Moderate


High
LDL-P (nmol/L)592-2404<935935-1816>1816
Small LDL-P (nmol/L)<1408<467467-820>820
LDL Size (nm)20.0-22.3>20.5N/A≤20.5
HDL-P (µmol/L)21.1-43.4>32.829.2-32.8<29.2
Large HDL-P (µmol/L)>3.5>7.25.3-7.2<5.3
HDL Size (nm)8.3-10.5>9.08.7-9.0<8.7
Large VLDL-P (nmol/L)<16.0<3.73.7-6.1>6.1
VLDL Size (nm)41.1-61.7<47.147.1-49.0>49.0
 Age (years)

Low
(mg/dL)
Relative Risk Range

Moderate
(mg/dL)


High
(mg/dL)
Total Cholesterol<20 years<170N/A≥170
≥20 years<200N/A≥200
HDL Cholesterol<20 years>45N/A≤45
≥20 years, Male≥40N/A<40
≥20 years, Female≥50N/A<50
Triglycerides<10 years<75N/A≥75
10-19 years<90N/A≥90
≥20 years<150150-199≥200
LDL-Cholesterol Calculated <20 years<110N/A≥110
≥20 years<100100-129≥130
Cholesterol/HDL-CAll Ages≤3.53.6-5.0>5.0
Non-HDL Cholesterol<20 years<120N/A≥120
≥20 years<130130-189≥190
TG/HDL-CAll Ages<2.02.0-3.0>3.0

Clinical Significance: The Lipoprotein Fractionation NMR test is used to help assess the risk for cardiovascular disease (CVD) in patients with intermediate or high risk based on traditional or emerging risk factors, and to assess therapeutic response in patients undergoing lipid-lowering therapy, by quantification of the number and size of lipoprotein particles. The lipid panel is used, along with other test, during routine assessment to determine an individual’s risk of cardiovascular disease. A lipid panel can also be used to monitor the efficacy of lifestyle interventions or medications.

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.