Summary & Overview
CPT 3049F: LDL Cholesterol 100–129 mg/dL
CPT code 3049F identifies the most recent low density lipoprotein cholesterol (LDL-C) result in the range of 100–129 mg/dL. LDL-C is a core laboratory marker used to stratify cardiovascular risk and guide clinical decisions about lipid-lowering therapy. Nationally, standardized reporting of LDL-C values supports quality measurement, population health management, and adherence to clinical guidelines.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for the LDL-C result captured by 3049F, how the code maps to outpatient laboratory services, and what the code signifies for quality measurement and care management programs.
This publication covers benchmarks and reporting considerations for 3049F, explains typical sites of service where the test is performed, and summarizes how this code is used within performance measurement frameworks. Data not available in the input is noted where relevant.
Billing Code Overview
CPT code 3049F denotes the most recent LDL C (low density lipoprotein cholesterol) measurement with a value of 100–129 mg/dL. The test is a component of a lipid profile used to assess cholesterol levels and inform cardiovascular risk assessment.
Service type: Laboratory test — lipid panel component (LDL cholesterol)
Typical site of service: Outpatient laboratory, hospital outpatient department, or clinic-based phlebotomy
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with known hyperlipidemia and type 2 diabetes presents for routine follow-up in an outpatient primary care clinic. The clinician orders a fasting lipid panel including a low-density lipoprotein cholesterol test to assess cardiovascular risk and medication effectiveness. Blood is drawn in the clinic laboratory or an affiliated phlebotomy site. The laboratory performs the LDL-C assay and reports a result of 100–129 mg/dL, which is documented as the most recent LDL-C in the medical record using CPT 3049F. Results are reviewed by the provider during a follow-up visit or via the electronic health record; medication adjustments, adherence counseling, or referral to cardiology may follow depending on the overall risk profile. Typical sites of service include outpatient primary care offices, ambulatory clinics, and outpatient laboratory/phlebotomy centers. Common patient workflow: order placed by clinician → specimen collected (clinic or lab) → lab processes lipid panel → result posted to chart and coded with 3049F when LDL-C falls in the 100–129 mg/dL range → clinician documents interpretation and any treatment changes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | Use as the default when no other modifier applies to the outpatient LDL-C laboratory reporting. |