Lipid Panel, Non-Fasting without Triglycerides

Test Code

91247

CPT Codes
82465, 83718

Includes

Cholesterol, Total
HDL Cholesterol
Cholesterol/HDL Ratio (calculated)
Non-HDL Cholesterol (calculated)

Preferred Specimen

1 mL serum collected in a serum separator tube (SST®)

Patient Preparation
If an HDL Cholesterol measurement is to be performed along with Triglycerides, the patient should be fasting 9-12 hours prior to collection.

Minimum Volume

0.5 mL

Other Acceptable Specimens

Plasma collected in: Sodium or lithium heparin (green-top) tube

Instructions

The assay manufacturer Beckman Coulter advises: "N-Acetyl Cysteine (NAC), when administered in therapeutic concentrations (for the treatment of acetaminophen overdose), has been...determined to interfere with assays for... Cholesterol, Uric Acid" where "NAC interference may lead to falsely low results." According to Beckman Coulter, the NAC interference should be insignificant by 12 hours after completion of the initial loading dose of an IV infusion treatment regimen consisting of an initial loading dose of 150 mg/kg administered over 1 hour, a second dose of 50 mg/kg administered over 4 hours and a third dose of 100 mg/kg administered over 16 hours.

Transport Container

Serum Separator Tube (SST®)

Transport Temperature

Refrigerated (cold packs)

Specimen Stability

Serum
Room temperature: 48 hours
Refrigerated: 7 days
Frozen: 28 days

Heparinized plasma
Room temperature: 48 hours
Refrigerated: 48 hours
Frozen: 28 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Gross hemolysis • Anticoagulants other than heparin • Moderate to gross icterus

Methodology
Spectrophotometry (SP)

Setup Schedule

Set up: Daily; Report available: Next day

Reference Range

Total Cholesterol	Male (mg/dL)	Female (mg/dL)
<20 Years	<170	<170
≥20 Years	<200	<200
HDL Cholesterol
<20 Years	>45	>45
≥20 Years	≥40	≥50

Cholesterol/HDL Ratio (calc)	<5.0	<5.0
Non-HDL Cholesterol (calc)
<20 Years	<120	<120
≥20 Years	<130	<130

Clinical Significance

This Lipid Panel includes Total Cholesterol, HDL Cholesterol and calculated non-HDL Cholesterol. It does not include triglycerides and may be best used in patients for whom fasting is difficult.

Performing Laboratory

Quest Diagnostics Nichols Institute

14225 Newbrook Drive

Chantilly, VA 20153

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.