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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.
This question was answered in an edition of our Laboratory Compliance Manager. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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