Lipids Testing
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1 Previously Listed as Edit Lipids Testing 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 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. HCPCS s (Alphanumeric, CPT AMA) Lipid panel Cholesterol, serum or whole blood, total Lipoprotein, blood; electrophoretic separation and quantitation Lipoprotein blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (e.g., electrophoresis, ultracentrifugation) Lipoprotein, blood; quantitation of lipoprotein particle numbers and lipoprotein particle subclasses Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) Lipoprotein, direct measurement, LDL cholesterol Triglycerides Fu Associates, Ltd. 99 January 2013
2 ICD-9-CM s Covered by Medicare Program The individual ICD-9-CM codes included in code ranges in the table below can be viewed on CMS website under Downloads: Lab List. The link is: :// Disorders of the thyroid gland with hormonal dysfunction Secondary diabetes mellitus without mention of complication Secondary diabetes mellitus with ketoacidosis Secondary diabetes mellitus with hyperosmolarity Secondary diabetes mellitus with other coma Secondary diabetes mellitus with renal manifestations Secondary diabetes mellitus with ophthalmic manifestations Secondary diabetes mellitus with neurological manifestations Secondary diabetes mellitus with peripheral circulatory disorders Secondary diabetes mellitus with other specified manifestations Secondary diabetes mellitus with unspecified complication Diabetes mellitus Cushing s syndrome 260 Kwashiorkor 261 Nutritional marasmus 262 Other severe, protein-calorie malnutrition Malnutrition of moderate degree Malnutrition of mild degree Other protein-calorie malnutrition Unspecified protein-calorie malnutrition Disturbances of amino-acid transport Galactosemia Pure hypercholesterolemia Hypertriglyceridemia Mixed hyperlipidemia (tuberous xanthoma) Hyperchylomicronemia Other and unspecified hyperlipidemia (unspecified xanthoma) Lipoprotein deficiencies Lipodystrophy Lipidoses Other disorders of lipoid metabolism Unspecified disorders of lipoid metabolism Amyloidosis, unspecified Familial Mediterranean fever Other amyloidosis Fu Associates, Ltd. 100 January 2013
3 Obesity Morbid obesity Overweight Obesity hypoventilation syndrome Alcoholism Other background retinopathy and retinal vascular change Retinal vascular occlusion Retinal exudates and deposits Senile corneal changes Xanthelasma Crystalline deposits in vitreous Degenerative & vascular disorder of ear, unspecified Transient ischemic deafness 401.0, 401.1, Essential hypertension Hypertensive heart disease Hypertensive chronic kidney disease Hypertensive heart and chronic kidney disease Secondary hypertension Acute myocardial infarction Other acute & subacute forms of ischemic heart disease Coronary occlusion without myocardial infarction Other acute and subacute ischemic heart disease 412 Old myocardial infarction Angina pectoris Other and unspecified angina pectoris Coronary atherosclerosis Coronary atherosclerosis, of artery bypass graft Coronary atherosclerosis, of unspecified graft Coronary atherosclerosis, of coronary artery of transplanted heart Coronary atherosclerosis, of bypass graft (artery) (vein) of transplanted heart Aneurysm of heart (wall) Coronary vessel aneurysm Dissection of coronary artery Other aneurysm of heart Coronary atherosclerosis due to lipid rich plaque Coronary atherosclerosis due to calcified coronary lesion Other specified forms of chronic ischemic heart disease Chronic ischemic heart disease, unspecified Heart failure Fu Associates, Ltd. 101 January 2013
4 429.2 Heart disease, unspecified Heart disease NOS 431 Intracerebral hemorrhage Occlusion & stenosis of precerebral arteries Occlusion of cerebral arteries Transient cerebral ischemia Cerebral atherosclerosis Other generalized ischemic cerebrovascular disease Moyamoya disease 438.0, , , , , , , 438.6, 438.7, , , Late effects of cerebrovascular disease Atherosclerosis of aorta; of other arteries; of bypass grafts Chronic total occlusion of the artery of the extremities Atherosclerosis of other specified arteries; generalized and unspecified atherosclerosis Aortic aneurysms and dissection Upper extremity aneurysm Renal artery aneurysm Iliac artery aneurysm , , Arterial embolism and thrombosis Chronic vascular insufficiency of intestine Other chronic non-alcoholic liver disease Unspecified chronic liver disease without mention of alcohol Hepatopulmonary syndrome Other specified disorders of liver Unspecified disorders of liver Pancreatic disease Other & unspecified postsurgical nonabsorption Other specified intestinal malabsorption Nephrotic syndrome Acute kidney failure with lesion of tubular necrosis Chronic kidney disease Renal osteodystrophy Nephrogenic diabetes insipidus Secondary hyperparathyroidism (of renal origin) Other specified disorders resulting from impaired renal function Fu Associates, Ltd. 102 January 2013
5 588.9 Unspecified disorder resulting from impaired renal function Impotence of organic origin, penis disorder Liver disorders in pregnancy Liver and biliary tract disorders in pregnancy, antepartum condition or complication Thyroid dysfunction in pregnancy and the puerperium Psoriatic arthropathy Other psoriasis Biliary atresia Light for dates with signs of fetal malnutrition Chest pain, unspecified Precordial pain Chest pain, other Hepatomegaly Abnormal transaminase Abnormal alkaline phosphatase Other abnormal blood chemistry Nonspecific (abnormal) findings on radiological and other examination of gastrointestinal tract Toxic effect of unspecified gas or vapor Complication of transplanted organ, kidney V42.0 Transplanted organ, kidney V42.7 Organ replacement by transplant, liver V58.63-V58.64 Long-term (current) drug use V58.69 Long term (current) use of other medications V81.0-V81.2 Covered only for procedure codes 80061, 82465, & Special screening for cardiovascular, respiratory, and genitourinary diseases Indications The medical community recognizes lipid testing as appropriate for evaluating atherosclerotic cardiovascular disease. Conditions in which lipid testing may be indicated include: Assessment of patients with atherosclerotic cardiovascular disease Evaluation of primary dyslipidemia Any form of atherosclerotic disease, or any disease leading to the formation of atherosclerotic disease Diagnostic evaluation of diseases associated with altered lipid metabolism, such as: nephrotic syndrome, pancreatitis, hepatic disease, and hypo and hyperthyroidism Fu Associates, Ltd. 103 January 2013
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