Laboratory Question for the Week of November 26, 2018

Laboratory Compliance Question of the Week

Question:

Can CPT code 83721 (lipoprotein, direct measurement; direct measurement, LDL cholesterol) be used to report a calculated LDL cholesterol?

Answer:

According to the National Correct Coding Initiate Manual for Medicare Services, the answer is no. Direct measurement of LDL cholesterol in addition to total cholesterol (CPT code 82465) or lipid panel (80061) may be reasonable and necessary if the triglyceride level is too high (greater than or equal to 400 mg/dl) to permit calculation of the LDL cholesterol. In such situations, CPT code 83721 should be reported with modifier 59.


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