MEDICAID CODING GUIDELINE EFFECTIVE: 1-1-03

LIPID PROFILE / CHOLESTEROL CPT CODES: 80061 Lipid panel ( this panel must include procedures 82465, 83718

and 84478) 82465 Cholesterol, serum, total 83715 Lipoprotein, blood; electrophoretic separation and quantitation 83716 High resolution fractionation and quantitation of lipoprotein

cholesterol�s (e.g., electrophoresis, nuclear magnetic resonance, ultracentrifugation)

83718 Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol)

83719 direct measurement, VLDL cholesterol 83721 direct measurement, LDL cholesterol 84478 Triglycerides effective for services on/after February 1, 1997 COVERED DIAGNOSIS: 240.0-246.9 Disorders of the thyroid gland 250.00-250.9 Diabetes mellitus 255.0 Cushing�s syndrome 260 Kwshiorkor 261 Nutritional marasmus 262 Other severe, protein-calorie malnutrition 263.0 Malnutrition of moderate degree 263.1 Malnutrition of mild degree 263.8 Other protein-calorie malnutrition 263.9 Other unspecified protein-calorie malnutrition 270.0 Disturbances of amino-acid transport 271.1 Galactosemia 272.0-272.8 Disorders of lipoid metabolism 272.9 Unspecified disorders of lipoid metabolism 303.90-303.92 Alcoholism 362.13 Changes in vascular appearance, vascular sheathing of retina 262.82 Retinal exudates and deposits 379.22 Crystalline deposits in vitreous 388.00 Degenerative and vascular disorders of ear, unspecified 401.0-405.99 Hypertension, hypertensive heart disease 410.00-410.92 Acute MI 411.0-411.1 Other acute and subacute forms of ischemic heart disease 411.81 Acute coronary occlusion without MI 411.89 Other, coronary insufficiency (acute), subendocardial ischemia 412 Old myocardial infarction 413.0-413.1 Angina pectoris 413.9 Other and unspecified angina pectoris 414.00-414.05 Other forms of chronic ischemic heart disease 414.10-414.11 Aneurysm of heart 414.19 Other, arteriovenous fistula, acquired, of heart 414.8 Other specified forms of chronic ischemic heart disease 414.9 Chronic ischemic heart disease, unspecified

427.0-427.9 Paroxysmal ventricular tachycardia, up to and including 428.0-428.9 Heart failure 429.2 Cardiovascular disease, unspecified 431-437.9 Cerebrovascular disease 438-438.9 Late effects of cerebrovascular disease 440.0-440.9 Arteriosclerosis 441.00-441.9 Aortic aneurysms 443.0-448.9 Peripheral vascular disease 557.1 Chronic vascular insufficiency of intestine 570-573.9 Acute and subacute necrosis of liver 574.00-574.91 Cholelithiasis 575.2 Obstruction of gallbladder 575.6 Cholesterolosis of gallbladder 576.2 Obstruction of bile duct 576.8 Other specified disorders of biliary tract 577.0-577.9 Pancreatic disease 579.3 Other and unspecified post-surgical non-absorption 579.8 Other specified intestinal malabsorption 581.0-581.9 Nephrotic syndrome 584.5 Acute renal failure with lesion of tubular necrosis 588.1 Nephrogenic diabetes insipidus 588.8 Other specified disorders resulting from impaired renal function 646.70-646.71 Liver disorders in pregnancy 646.73 Liver disorders in pregnancy, antepartum condition or complication 648.10-648.14 Thyroid dysfunction 746.85 Coronary artery anomaly 751.61 Biliary atresia 764.10-764.19 �Light-for-dates� with signs of fetal malnutrition 786.50 Chest pain, unspecified V12.59 Other diseases of circulatory system V42.0 Kidney replaced by transplant V42.1 Heart replaced by transplant V45.81 Aortocoronary bypass status V45.82 Percutaneous transluminal coronary angioplasty status V67.51 Following treatment with high risk medication, not elsewhere classified MC Part B News, Apr, 2000 Revised: SP/ 2-27-02