Pathology/Lab Coding Alert

Reader Questions:

Distinguish LDL Fractions

Question: The lab performs a test to measure levels of “small dense low-density lipoprotein.” Should we code this as 83719?

Washington Subscriber

Answer: No, you should not report 83719 (Lipoprotein, direct measurement; VLDL cholesterol) for a lab test that directly measures the level of small dense low-density lipoprotein ([sd] LDL). The more specific code for the test is 83722 (… small dense LDL cholesterol).

The difference: The tests may use similar lab methods, such as centrifuging the blood specimen to separate fractions by density, then adding a specific reagent that reacts with the desired fraction and serves as a marker that allows detection and measurement. You must pay close attention to the cholesterol fraction name to make sure you select the correct code.