Last Modified:
9/19/2019 1:59:40 PM
Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
For optimum results, the patient conditions at the time of sample collection should be:
a. Following a stable diet for at least a week.
b. Stable body weight.
c. Fasting for at least 12 hours (12 to 16 hours).
Specimen Requirements:
2.0 mL Serum from a Red Top Tube in a Plastic Vial
Collection Instructions:
Centrifuge and separate from cells within 1 hour of collection
Minimum Volume:
1.0 mL Serum
Transport & Storage: Temperature/Stability:
7 days Refrigerated
14 days Frozen
Rejection Criteria:
Hemolysis; Ambient
Reference Range:
Refer to Interpretive Results
Critical Ranges:
Test Comments:
Methodology:
Agarose Electrophoresis (AE)
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Turn Around Time:
7 to 10 days
Days Performed:
Sunday, Wednesday
Sites Performed:
Quest - Chantilly to San Juan Capistrano
Other Testing Facility:
Quest San Juan Capistrano
PHL Test Code:
LIPE
EPIC Test Code:
LAB100
Send Out Test Code:
35436
Alternate Test Names:
LPE
Included Tests:
Cholesterol; Electrophoresis; Interpretation; Triglyercide
CPT Coding:
82465, 83700, 84478
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