Laboratory Test for Measuring Apolipoprotein A-I and B Levels
CPT® code 82172 is used to report a quantitative laboratory test that measures the levels of apolipoprotein A-I (ApoA-I) and apolipoprotein B (ApoB) in a patient’s serum. These proteins play a critical role in lipid metabolism—ApoA-I is the primary protein in HDL (“good cholesterol”), while ApoB is the main component of LDL (“bad cholesterol”). The test helps evaluate cardiovascular risk and monitor lipid-lowering therapy effectiveness.
When to Use CPT® Code 82172
Report 82172 when:
- The provider orders a quantitative assay for both ApoA-I and ApoB levels in serum or plasma.
- The test is used to assess lipid metabolism disorders, dyslipidemia, or cardiovascular disease risk.
- Results guide treatment decisions for patients on statins or other lipid-lowering medications.
- The test is performed using a validated immunoassay or comparable quantitative methodology.
If only one of the apolipoproteins (A-I or B) is tested, report CPT® 82172 once; the code covers both components when performed together.
Documentation Requirements
Clear documentation supports accurate billing and clinical interpretation. Include:
- The clinical indication (e.g., hyperlipidemia, atherosclerosis, cardiovascular disease monitoring)
- Date and time of specimen collection
- Specimen type (serum or plasma) and testing method
- Quantitative results for ApoA-I and ApoB with reference ranges
- Ordering provider’s name, credentials, and signature
Link the test to an appropriate ICD-10 diagnosis such as E78.5 (hyperlipidemia, unspecified) or I25.10 (atherosclerotic heart disease of native coronary artery).
Billing Guidelines
- CPT® 82172 represents a single, quantitative test measuring both ApoA-I and ApoB.
- The test may be performed individually or as part of an advanced lipid panel.
- Do not report 82172 with other lipid tests unless separately ordered and documented.
- Coverage and reimbursement vary; some payers may require documentation of cardiovascular risk or abnormal lipid profiles.
- Repeat testing should be supported by medical necessity (e.g., therapy monitoring or disease progression).
Example
A provider orders an apolipoprotein A-I and B test for a patient with a history of coronary artery disease and elevated LDL levels to monitor response to statin therapy. The laboratory performs a quantitative immunoassay and reports both ApoA-I and ApoB results. The service is billed under CPT® code 82172 with supporting diagnostic documentation.
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