REPORTING AND REFLEX ALGORITHM CHANGE
Lipid Panel
Order Code: LIPID
Fee Code: 20912 (CPT 80061)
Effective July 1, 2024, the MLabs Clinical Core Chemistry Laboratory will report calculated LDL-cholesterol (LDL-C) in the lipid panel (order code LIPID) using the Martin-Hopkins equations. A non-orderable component NFAC will be added to the panel for a novel factor used by the Martin-Hopkins equations to calculate the LDLC; this component will not be reported.
LDL-cholesterol is estimated using a calculation. Currently, LDL-C is routinely calculated by clinical laboratories using the Friedewald equation, which has decreased accuracy compared to other estimations, especially when triglycerides are elevated, or the true LDL is low. Recent guidelines recommend the adoption of new equations that are more accurate at estimating LDL-cholesterol. The replacement of the Friedewald equation with Martin-Hopkins equation, may result in a change in LDL-cholesterol estimation for some patients. The largest shifts will be for those with elevated triglycerides. Since the Martin-Hopkins equations are validated for triglycerides up to 800 mg/dL, reflex to Direct LDL-Cholesterol will now be performed only for specimens where triglycerides are equal and greater than 800 mg/dL (compared to 400 mg/dL for the Friedewald equation).