Lipoprotein, direct measurement; low-density lipoprotein (LDL)
Relative Value Units (RVUs)
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Clinical Information
When to Use
Quantitative measurement of LDL cholesterol level in blood using direct measurement method
Common Scenarios
Documentation Requirements
- Order from physician required
- Test results documented
- Normal range: <100 mg/dL (optimal), <130 mg/dL (near optimal)
- Clinical interpretation if applicable
Coding Guidelines
Common Modifiers
Bundling Rules
- LDL cholesterol direct measurement
- May be billed with other lipid tests on same day
Exclusions
- Do not bill if included in lipid panel (80061)
Coding Notes
Clinical scenarios
- Order from physician required
- Test results documented
- Normal range: <100 mg/dL (optimal), <130 mg/dL (near optimal)
- Order from physician required
- Test results documented
- Normal range: <100 mg/dL (optimal), <130 mg/dL (near optimal)
- Order from physician required
- Test results documented
- Normal range: <100 mg/dL (optimal), <130 mg/dL (near optimal)
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Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
National Limit: $10.50
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Ask a QuestionFrequently Asked Questions
CPT 83721 is the billing code for "Lipoprotein, direct measurement; low-density lipoprotein (LDL)". Quantitative measurement of LDL cholesterol level in blood using direct measurement method
CPT 83721 has a total RVU of 0.56, broken down as: Work RVU 0.05, Practice Expense RVU 0.50, and Malpractice RVU 0.01. RVUs (Relative Value Units) determine Medicare reimbursement rates.
Key documentation requirements for CPT 83721 include: Order from physician required; Test results documented; Normal range: <100 mg/dL (optimal), <130 mg/dL (near optimal); Clinical interpretation if applicable. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 83721: LDL cholesterol direct measurement. May be billed with other lipid tests on same day Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 83721 include: 26 (Professional component only (interpretation)), TC (Technical component only (performance)), 91 (Repeat clinical diagnostic laboratory test, same day). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 83721 is Automated testing - results typically available within hours. Time-based codes require documentation of the actual time spent providing the service.