Lipid Panel

CPT Test code: 80061

Related Documents:	• Spanning the Continuum of Cardiovascular Care
Test Includes:	Cholesterol, total; high-density lipoprotein (HDL) cholesterol; low-density lipoprotein (LDL) cholesterol (calculation); triglycerides; very low-density lipoprotein (VLDL) cholesterol (calculation)
Related Information:	High-density Lipoprotein Cholesterol (HDL-C) Lipids Appendix: Clinical Conditions Associated With Cardiovascular Disease Lipids Appendix: Clinical Utility Test List Low-density Lipoprotein Cholesterol (Direct)
Specimen:	Serum (preferred) or plasma
Volume:	2 mL
Minimum Volume:	0.5 mL
Container:	Gel-barrier transport, green-top (heparin) tube, or lavender-top (EDTA) tube
Special Instructions:	State patient’s age and sex on the request form.
Collection:	Separate serum or plasma or from cells within 45 minutes of collection. Lipid panels are best avoided for three months following acute myocardial infarction, although cholesterol can be measured in the first 24 hours.
Storage Instructions:	Maintain specimen at room temperature.
Patient Preparation:	Patient should be on a stable diet, ideally for two to three weeks prior to collection of blood, and should fast for 12 to 14 hours before collection of the specimen.
Causes for Rejection:	Hemolysis
Use:	Evaluate hyperlipidemia as an index to coronary artery disease
Limitations:	Patients with obstructive liver disease may develop lipoprotein abnormalities. Serum lipid factors have not been demonstrated to have a strong influence on recurrent stenosis following coronary angioplasty, the pathogenesis of which is presently not well understood. LDL cholesterol cannot be calculated if triglyceride is >400 mg/dL.
Additional Information:	Investigation of serum lipids is indicated in those with coronary and other arterial disease, especially when it is premature, and in those with family history of atherosclerosis or of hyperlipidemia. In this sense, the expression “premature” is mostly used to include those younger than 40 years of age. Patients with xanthomas should be worked up with lipid panels but not those with xanthelasmas or xanthofibromas in the sense of dermatofibromas. Those whose fasting serum is lipemic should have a lipid panel, but the serum of a subject with high cholesterol (but normal triglyceride) is not milky in appearance. The patient with high cholesterol (>240 mg/dL) should have a lipid panel. Patients with cholesterol levels between 200-240 mg/dL plus two other coronary heart disease risk factors should also have a lipid panel.¹ In addition to application in screening programs for evaluation of risk factors for coronary arterial disease, lipid profiling may lead to detection of some cases of hypothyroidism. Primary hyperlipoproteinemia includes hypercholesterolemia, a direct risk factor for coronary heart disease. Secondary hyperlipoproteinemia includes increases of lipoproteins secondary to hypothyroidism, nephrosis, renal failure, obesity, diabetes mellitus, alcoholism, primary biliary cirrhosis, and other types of cholestasis. Decreased lipids are found with some cases of malabsorption, malnutrition, and advanced liver disease. In abetalipoproteinemia, cholesterol is <70 mg/dL.
Footnotes:	1. Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. The Expert Panel. Arch Intern Med. 1988 Jan; 148(1):36-69.PubMed 3422148