In medical coding, we have different facilities. I have shared lot of information on diagnostic and interventional radiology facility, but today I will share some coding guide on laboratory test. Yes, today I will share how a lipid panel is coded using a procedure code. Lipid panel CPT code 80061 is used when all the test included in the lipid panel are done.

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Detail Code description of Lipid panel CPT code 80061

The Lipid panel includes three test, cholesterol serum, lipoprotein and triglycerides. As per guidelines, the coders should use assign code 80061 only when all the three test are done in the medical report.

The lipid panel is used, along with other tests, 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.

80061 – Lipid panel

Cholesterol, serum, total (82465)
Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718)
Triglycerides (84478)

If any of these laboratory test is missing, then the coder should report lab test with their individual procedure code. For example, if Cholesterol and lipoprotein test is only done, then we can go ahead and code CPT code 82465 and 83718 only.

Lipoproteins are a class of heterogeneous particles of varying sizes and densities containing lipid and protein. These lipoproteins include cholesterol esters and free cholesterol, triglycerides, phospholipids and A, C, and E apoproteins. Total cholesterol comprises all the cholesterol found in various lipoproteins.

Factors that affect blood cholesterol levels include age, sex, body weight, diet, alcohol and tobacco use, exercise, genetic factors, family history, medications, menopausal status, the use of hormone replacement therapy, and chronic disorders such as hypothyroidism, obstructive liver disease, pancreatic disease (including diabetes), and kidney disease.

In many individuals, an elevated blood cholesterol level constitutes an increased risk of developing coronary artery disease. Blood levels of total cholesterol and various fractions of cholesterol, especially low density lipoprotein cholesterol (LDL -C) and high density lipoprotein cholesterol (HDL-C) are useful in assessing and monitoring treatment for that risk in patients with cardiovascular and related diseases.

Blood levels of the above cholesterol components including triglyceride have been separated into desirable, borderline and high-risk categories by the National Heart, Lung, and Blood Institute in their report in 1993. These categories form a useful basis for evaluation and treatment of patients with hyperlipidemia. Therapy to reduce these risk parameters includes diet, exercise and medication, and fat weight loss, which is particularly powerful when combined with diet and exercise.

Diagnosis related to CPT code 80061

Diagnosis or the medical necessity is very important for billing of procedure code. The diagnosis should fulfill the CPT code. Below are few example of the required ICD 10 codes for CPT code 80061

Inability to stabilize lipid-lowering drug dosing (Z79.899).

Adverse reaction to lipid-lowering drug (Z79.899)

Hyperlipidemia, Unspecified (ICD 10-E78.5, ICD 9-272.4)

Hypercholesterolemia(ICD 10 E78.0, ICD 9 -272.0)