Last Modified:
4/12/2019 10:14:15 AM
Medicare Medical Necessity Restrictions May Apply
Medical Necessity Documentation:
Client Notes:
Patient Preparation:
Specimen Requirements:
1.0 mL Plasma in a PST Mint Green Top Tube - Li Heparin
Collection Instructions:
Minimum Volume:
0.2 mL
Transport & Storage: Temperature/Stability:
3 days Refrigerated
3 hours on cells
Reference Range:
Desirable: <130 mg/dL
Borderline Risk: 130 - 159 mg/dL
High Risk: >160 mg/dL
Critical Ranges:
Test Comments:
Methodology:
Enzymatic
Clinical Significance:
Documentation:
Custom Panel:
No
PRODUCTION SCHEDULE
Days Performed:
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed:
Parkview Regional Medical Center
PHL Test Code:
LDL
EPIC Test Code:
LAB102
Alternate Test Names:
Direct LDL; LDL-C
Included Tests:
CPT Coding:
83721
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