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Test Code LIPOB Lipoprotein Panel, No LDL

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 hours	Plasma/Serum	Lithium-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

Test Components

Includes Total Cholesterol, HDL Cholesterol, and Triglyceride.

Interferences

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.

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
	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

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

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

Marshfield Labs Performing Department

Marshfield Labs Chemistry

Performing Information

Performing Location	Day(s) Test Performed	Analytical Time	Methodology/Instrumentation
Beaver Dam	Monday through Sunday	Less than 2 hours	See Individual Tests for Methodology/ Beckman AU
Weston	Monday through Sunday	Less than 2 hours	See Individual Tests for Methodology/ Beckman AU
Eau Claire	Monday through Sunday	Less than 2 hours	See Individual Tests for Methodology/ Beckman AU
Rice Lake	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

CPT Codes

CPT	Modifier (if needed)	Quantity	Description	Comments
80061

Outreach CPT Codes

CPT	Modifier (if needed)	Quantity	Description	Comments
80061

Ordering Applications

Ordering Application	Description
Cerner	Lipoprotein Panel, No LDL

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