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23101 Lipoprotein Panel, No LDL

Lipoprotein Panel, No LDL
Test Code: LIPOB
Test Components
Includes Total Cholesterol, HDL Cholesterol, and Triglyceride.​
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Preferred 9-12 hoursPlasma​/SerumLithium-heparin Plasma Separator (PST)​, Serum Separator Tube (SST)Lithium or Sodium-heparin Green Top (GTT), Red Top Tube (RTT)1 mL​0.5 mL​ ​
Collection Processing Instructions

​​Samples collected in gel tubes should be centrifuged within 2 hours of collection.

Samples collected in non-gel tubes must be centrifuged and aliquoted from cells within 2 hours of collection.

Specimen Stability Information
Specimen Type Temperature Time
Plasma/Serum​ ​ Ambient​ 5 days​
Refrigerate​ 7 days​
​Frozen ​30 days
Interference

For Regional Centers performing Triglyceride: N-Acetylcysteine (NAC) may interfere with the Siemens Dimension triglyceride assay and cause falsely depressed results.

For patients receiving NAC treatment, venipuncture should occur prior to NAC administration to prevent this interference.

Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Chippewa Falls​ ​Monday through Friday ​Less than 2 hours​ ​See Individual Tests for Methodology
​Weston
 ​Monday through Sunday​ ​Less than 2 hours​ See Individual Tests for Methodology
​Eau Claire ​Monday through Sunday​ ​Less than 2 hours​ See Individual Tests for Methodology/ Beckman AU​
​Lakeview Medical Center ​Monday through Sunday​ ​Less than 2 hours​ ​See Individual Tests for Methodology/ Beckman AU​
Marshfield​ Monday through Sunday​ Less than 2 hours​ See Individual Tests for Methodology/ Beckman AU​
​Minocqua ​Monday through Sunday​ ​Less than 2 hours​ ​See Individual Tests for Methodology/ Beckman AU​
​Wisconsin Rapids ​Monday through Friday ​Less than 2 hours​ ​See Individual Tests for Methodology
Reference Range Information
Performing Location Reference Range
All Performing Sites using Dimension
Panel includes the following tests:
Cholesterol:
            0-20 yrs: 100-170 mg/dL  (Marked increase: >200mg/dL)
            >20 yrs: 100-200 mg/dL   (Marked increase: >240 mg/dL)
HDL Cholesterol:
            40-59 mg/dL (HDL >= 60 is considered cardio-protective)
Triglycerides:
            20-149 mg/dL
non-HDL Cholesterol (mg/dL):
            <130 if CHD, peripheral vascular disease, or diabetes is present
            <160 when no CHD is present, but there are 2 or more risk factors
            <190 when there is no CHD, but there is 0 or 1 risk factor present
CHD Risk Factors:
            Cigarette smoking
            Hypertension
                    BP > 140/90 mm Hg or on antihypertensive medication
            Low HDL-C (<40 mg/dL)
                    HDL-C > 60 mg/dL counts as a “negative” risk factor; if present,
                       remove one risk factor from the total count
            Family history of premature CHD
                    CHD in male first degree relative <55 years
                    CHD in female first degree relative <65 years
            Age
                    Men > 45 years
                    Women > 55 years ​
All Performing Sites using ​Beckman AU​
 ​Panel includes the following tests:
Cholesterol:
             0-20 yrs: 100-170 mg/dL (Marked increase: >200mg/dL)
             >20 yrs: 100-200 mg/dL (Marked increase: >240 mg/dL)
HDL Cholesterol:
             0 - 14 days: 13 - 39 mg/dL
             15 days - <1 yr: 9 - 69 mg/dL
             1 yr - <4 yr: 30 - 60 mg/dL
             4 - <13 yr: 33 - 70 mg/dL
             Female: 13 - <19 yr: 29 - 69 mg/dL
             Male: 13 - <19 yr: 29 - 66 mg/dL
             >=19 yr: 40 - 59 mg/dL
Triglycerides:
             0 – 14 days: 86 – 300 mg/dL
             15 days - <1 yr: 50 – 300 mg/dL
        1 - <19 yr: 40 – 225 mg/dL
        Adult >=19 yr: 20 - 149 mg/dL
non-HDL Cholesterol (mg/dL):
            <130 if CHD, peripheral vascular disease, or diabetes is present
            <160 when no CHD is present, but there are 2 or more risk factors
            <190 when there is no CHD, but there is 0 or 1 risk factor present
CHD Risk Factors:
            Cigarette smoking
            Hypertension
                   BP > 140/90 mm Hg or on antihypertensive medication
            Low HDL-C (<40 mg/dL)
                   HDL-C > 60 mg/dL counts as a “negative” risk factor; if present,
                   remove one risk factor from the total count
            Family history of premature CHD
                   CHD in male first degree relative <55 years
                   CHD in female first degree relative <65 years
            Age
                   Men > 45 years
                   Women > 55 years ​
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80061 ​ ​ ​ ​ ​
Test Components
Includes Total Cholesterol, HDL Cholesterol, and Triglyceride.​
Ordering Applications
Ordering Application Description
​Centricity ​Lipo Panel, No LDL
​Cerner ​Lipo Panel, no LDL
​COM ​Lipo Panel, no LDL
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Preferred 9-12 hoursPlasma​/SerumLithium-heparin Plasma Separator (PST)​, Serum Separator Tube (SST)Lithium or Sodium-heparin Green Top (GTT), Red Top Tube (RTT)1 mL​0.5 mL​ ​
Collection Processing

​​Samples collected in gel tubes should be centrifuged within 2 hours of collection.

Samples collected in non-gel tubes must be centrifuged and aliquoted from cells within 2 hours of collection.

Specimen Stability Information
Specimen Type Temperature Time
Plasma/Serum​ ​ Ambient​ 5 days​
Refrigerate​ 7 days​
​Frozen ​30 days
Interference

For Regional Centers performing Triglyceride: N-Acetylcysteine (NAC) may interfere with the Siemens Dimension triglyceride assay and cause falsely depressed results.

For patients receiving NAC treatment, venipuncture should occur prior to NAC administration to prevent this interference.

Test Components
Includes Total Cholesterol, HDL Cholesterol, and Triglyceride.​
Reference Range Information
Performing Location Reference Range
All Performing Sites using Dimension
Panel includes the following tests:
Cholesterol:
            0-20 yrs: 100-170 mg/dL  (Marked increase: >200mg/dL)
            >20 yrs: 100-200 mg/dL   (Marked increase: >240 mg/dL)
HDL Cholesterol:
            40-59 mg/dL (HDL >= 60 is considered cardio-protective)
Triglycerides:
            20-149 mg/dL
non-HDL Cholesterol (mg/dL):
            <130 if CHD, peripheral vascular disease, or diabetes is present
            <160 when no CHD is present, but there are 2 or more risk factors
            <190 when there is no CHD, but there is 0 or 1 risk factor present
CHD Risk Factors:
            Cigarette smoking
            Hypertension
                    BP > 140/90 mm Hg or on antihypertensive medication
            Low HDL-C (<40 mg/dL)
                    HDL-C > 60 mg/dL counts as a “negative” risk factor; if present,
                       remove one risk factor from the total count
            Family history of premature CHD
                    CHD in male first degree relative <55 years
                    CHD in female first degree relative <65 years
            Age
                    Men > 45 years
                    Women > 55 years ​
All Performing Sites using ​Beckman AU​
 ​Panel includes the following tests:
Cholesterol:
             0-20 yrs: 100-170 mg/dL (Marked increase: >200mg/dL)
             >20 yrs: 100-200 mg/dL (Marked increase: >240 mg/dL)
HDL Cholesterol:
             0 - 14 days: 13 - 39 mg/dL
             15 days - <1 yr: 9 - 69 mg/dL
             1 yr - <4 yr: 30 - 60 mg/dL
             4 - <13 yr: 33 - 70 mg/dL
             Female: 13 - <19 yr: 29 - 69 mg/dL
             Male: 13 - <19 yr: 29 - 66 mg/dL
             >=19 yr: 40 - 59 mg/dL
Triglycerides:
             0 – 14 days: 86 – 300 mg/dL
             15 days - <1 yr: 50 – 300 mg/dL
        1 - <19 yr: 40 – 225 mg/dL
        Adult >=19 yr: 20 - 149 mg/dL
non-HDL Cholesterol (mg/dL):
            <130 if CHD, peripheral vascular disease, or diabetes is present
            <160 when no CHD is present, but there are 2 or more risk factors
            <190 when there is no CHD, but there is 0 or 1 risk factor present
CHD Risk Factors:
            Cigarette smoking
            Hypertension
                   BP > 140/90 mm Hg or on antihypertensive medication
            Low HDL-C (<40 mg/dL)
                   HDL-C > 60 mg/dL counts as a “negative” risk factor; if present,
                   remove one risk factor from the total count
            Family history of premature CHD
                   CHD in male first degree relative <55 years
                   CHD in female first degree relative <65 years
            Age
                   Men > 45 years
                   Women > 55 years ​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Chippewa Falls​ ​Monday through Friday ​Less than 2 hours​ ​See Individual Tests for Methodology
​Weston
 ​Monday through Sunday​ ​Less than 2 hours​ See Individual Tests for Methodology
​Eau Claire ​Monday through Sunday​ ​Less than 2 hours​ See Individual Tests for Methodology/ Beckman AU​
​Lakeview Medical Center ​Monday through Sunday​ ​Less than 2 hours​ ​See Individual Tests for Methodology/ Beckman AU​
Marshfield​ Monday through Sunday​ Less than 2 hours​ See Individual Tests for Methodology/ Beckman AU​
​Minocqua ​Monday through Sunday​ ​Less than 2 hours​ ​See Individual Tests for Methodology/ Beckman AU​
​Wisconsin Rapids ​Monday through Friday ​Less than 2 hours​ ​See Individual Tests for Methodology
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
80061 ​ ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.