Summary & Overview

CPT 0377U: NMR Lipoprotein Profile (Liposcale®)

Headline: CPT code 0377U covers Liposcale®, an NMR-based lipoprotein profiling test that reports 23 variables of lipid particle size and number. Lead: CPT code 0377U designates a proprietary laboratory analysis (PLA) for Liposcale® from CIMA Sciences LLC, an advanced nuclear magnetic resonance (NMR) spectroscopy assay that produces a detailed lipoprotein profile from serum or plasma and may better predict adverse cardiovascular events.

Why it matters nationally: Advanced lipid particle profiling affects cardiovascular risk stratification and could influence diagnostic pathways, specialist referrals, and lab utilization across the country. As a PLA code tied to a single manufacturer, CPT code 0377U has implications for test identification, billing transparency, and payer coverage policy.

Key payers covered: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare are included in the payer overview.

What readers will learn: The publication provides benchmarks and coverage context for CPT code 0377U, explains the clinical context of NMR-based lipoprotein testing, and summarizes how the proprietary nature of the PLA code affects billing and traceability. It also highlights common billing modifiers and notes where input data are not available. The goal is to inform billing staff, laboratory managers, and policy analysts about the code’s purpose, service setting, and relevance to cardiovascular risk assessment.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0377UCPTProprietary Laboratory AnalysesNMR lipoprotein profileLiposcaleLaboratory testingCardiovascular riskPLA code

Billing Code Overview

CPT code 0377U is a Proprietary Laboratory Analyses (PLA) code reported only for Liposcale® produced by CIMA Sciences LLC. The test uses nuclear magnetic resonance (NMR) spectroscopy on a serum or plasma specimen to generate a detailed lipoprotein profile. The report identifies 23 variables describing lipid particle size and number that may more accurately predict adverse cardiovascular events.

Service type: Laboratory testing — specialized NMR-based lipoprotein analysis

Typical site of service: Clinical laboratory or reference laboratory processing serum or plasma specimens

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient with persistent dyslipidemia despite statin therapy is referred by a primary care physician to a lipidology clinic for advanced lipoprotein testing. The clinician orders the Liposcale® assay (0377U) to obtain a detailed NMR-derived lipoprotein particle profile from a fasting serum specimen. The typical clinical workflow: the phlebotomy team collects a serum or plasma sample during an outpatient laboratory visit; the specimen is sent to the performing laboratory or the manufacturer-designated reference lab (CIMA Sciences LLC); the lab runs NMR spectroscopy and generates a report of 23 lipoprotein variables including particle sizes and numbers; the lipid specialist reviews results in follow-up, uses the detailed profile to refine cardiovascular risk stratification, and documents interpretation in the outpatient medical record. Typical site of service is outpatient phlebotomy or clinical laboratory associated with an ambulatory clinic or reference lab.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the interpretation/reporting component by a physician or qualified provider separate from the laboratory technical component.
`TC`	Technical component	Use when billing only the laboratory's technical component (instrumentation, processing) for the NMR assay.
`52`	Reduced services	Use when the test was partially performed or limited compared with the full Liposcale® panel.
`53`	Discontinued procedure	Use when specimen collection or analysis was started but terminated due to patient or technical reasons.
`59`	Data not in provided modifier list; not allowed	Data not available in the input.
`QK`	Advanced diagnostic laboratory test (ADLT) specimen not used*	Use per payer policy when specimen handling or specialized logistics apply — verify payer rules.
`QX`	Ordering physician not servicing billing laboratory*	Use when modifier reporting is required to indicate the ordering vs performing lab relationships under certain contracts.
`QY`	Ordering physician reporting lab services*	Use in contexts where the ordering provider is also reporting services per payer rules.
`SH`	Diagnostic radiology services - supervision by nonphysician	Not typically applicable but included where supervision distinctions are required by payer policy.
`SJ`	Diagnostic radiology services - assistant at surgery	Not typically applicable for laboratory testing but may be used per institutional billing workflows.

Taxonomy Code	Specialty	Notes
207Q00000X	Clinical Cardiology	Cardiologists order advanced lipoprotein testing for cardiovascular risk stratification.
207L00000X	Preventive Medicine	Preventive medicine specialists managing primary prevention and detailed risk assessment.
207RH0000X	Clinical Lipidology	Lipid specialists and lipidologists interpret advanced lipoprotein profiles.
207K00000X	Internal Medicine	General internists commonly order specialized lipid testing in outpatient practice.
208000000X	Family Medicine	Family physicians ordering testing as part of longitudinal care.

*Modifiers beginning with Q and some SH/SJ usages may be payer-specific; verify payer rules prior to claim submission.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E78.0`	Pure hypercholesterolemia	Common indication for advanced lipoprotein particle testing to further stratify atherogenic risk.
`E78.2`	Mixed hyperlipidemia	Used when patients have combined dyslipidemia; NMR profiles help characterize particle subtypes.
`E78.5`	Hyperlipidemia, unspecified	General billing diagnosis when dyslipidemia is the clinical reason for testing.
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	Used when assessing residual risk in patients with established coronary disease.
`Z13.6`	Encounter for screening for cardiovascular disorders	Applicable when ordering advanced lipid testing for preventive screening in high-risk patients.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80061`	Lipid panel (total cholesterol, HDL, triglycerides, and calculation of LDL cholesterol)	Commonly ordered alongside `0377U` as routine lipid measures for comparative interpretation.
`84378`	Lipoprotein, direct measurement (eg, LDL-C direct)	May be performed when direct LDL measurement is needed in addition to NMR particle analysis.
`36415`	Collection of venous blood by venipuncture	Performed immediately prior to `0377U` testing as the specimen collection method for serum or plasma.
`81479`	Unlisted molecular pathology procedure	Occasionally used for associated specialized genetic or molecular tests ordered in complex lipid disorders when no specific CPT exists.
`93000`	Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	Performed in cardiovascular risk assessment visits that include advanced lipid testing.

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Summary & Overview

CPT 0377U: NMR Lipoprotein Profile (Liposcale®)

Key payers covered: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare are included in the payer overview.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0377UCPTProprietary Laboratory AnalysesNMR lipoprotein profileLiposcaleLaboratory testingCardiovascular riskPLA code

Billing Code Overview

Service type: Laboratory testing — specialized NMR-based lipoprotein analysis

Typical site of service: Clinical laboratory or reference laboratory processing serum or plasma specimens

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the interpretation/reporting component by a physician or qualified provider separate from the laboratory technical component.
`TC`	Technical component	Use when billing only the laboratory's technical component (instrumentation, processing) for the NMR assay.
`52`	Reduced services	Use when the test was partially performed or limited compared with the full Liposcale® panel.
`53`	Discontinued procedure	Use when specimen collection or analysis was started but terminated due to patient or technical reasons.
`59`	Data not in provided modifier list; not allowed	Data not available in the input.
`QK`	Advanced diagnostic laboratory test (ADLT) specimen not used*	Use per payer policy when specimen handling or specialized logistics apply — verify payer rules.
`QX`	Ordering physician not servicing billing laboratory*	Use when modifier reporting is required to indicate the ordering vs performing lab relationships under certain contracts.
`QY`	Ordering physician reporting lab services*	Use in contexts where the ordering provider is also reporting services per payer rules.
`SH`	Diagnostic radiology services - supervision by nonphysician	Not typically applicable but included where supervision distinctions are required by payer policy.
`SJ`	Diagnostic radiology services - assistant at surgery	Not typically applicable for laboratory testing but may be used per institutional billing workflows.

Taxonomy Code	Specialty	Notes
207Q00000X	Clinical Cardiology	Cardiologists order advanced lipoprotein testing for cardiovascular risk stratification.
207L00000X	Preventive Medicine	Preventive medicine specialists managing primary prevention and detailed risk assessment.
207RH0000X	Clinical Lipidology	Lipid specialists and lipidologists interpret advanced lipoprotein profiles.
207K00000X	Internal Medicine	General internists commonly order specialized lipid testing in outpatient practice.
208000000X	Family Medicine	Family physicians ordering testing as part of longitudinal care.

*Modifiers beginning with Q and some SH/SJ usages may be payer-specific; verify payer rules prior to claim submission.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E78.0`	Pure hypercholesterolemia	Common indication for advanced lipoprotein particle testing to further stratify atherogenic risk.
`E78.2`	Mixed hyperlipidemia	Used when patients have combined dyslipidemia; NMR profiles help characterize particle subtypes.
`E78.5`	Hyperlipidemia, unspecified	General billing diagnosis when dyslipidemia is the clinical reason for testing.
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	Used when assessing residual risk in patients with established coronary disease.
`Z13.6`	Encounter for screening for cardiovascular disorders	Applicable when ordering advanced lipid testing for preventive screening in high-risk patients.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80061`	Lipid panel (total cholesterol, HDL, triglycerides, and calculation of LDL cholesterol)	Commonly ordered alongside `0377U` as routine lipid measures for comparative interpretation.
`84378`	Lipoprotein, direct measurement (eg, LDL-C direct)	May be performed when direct LDL measurement is needed in addition to NMR particle analysis.
`36415`	Collection of venous blood by venipuncture	Performed immediately prior to `0377U` testing as the specimen collection method for serum or plasma.
`81479`	Unlisted molecular pathology procedure	Occasionally used for associated specialized genetic or molecular tests ordered in complex lipid disorders when no specific CPT exists.
`93000`	Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	Performed in cardiovascular risk assessment visits that include advanced lipid testing.