Summary & Overview
CPT 83722: Direct Measurement of Small Dense LDL Cholesterol
CPT code 83722 designates a laboratory test that directly measures small dense low–density lipoprotein (LDL) cholesterol in a patient specimen. The measure provides a more specific assessment of atherogenic LDL subfractions than standard LDL-C and can be used in clinical risk stratification and management of patients with dyslipidemia. Nationally, advanced lipid testing like this contributes to targeted preventive cardiology and precision risk assessment, with implications for laboratory service utilization and coverage policy.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for 83722, typical sites where the service is performed, and the relevance of direct small dense LDL measurement to patient management. The publication outlines billing and coding considerations, common modifiers, and what information is available for payers and coverage practices. Where input data is incomplete, the summary notes that specific taxonomy, diagnosis linkage, and related-code details are not available in the input.
Billing Code Overview
CPT code 83722 describes a laboratory assay in which a lab analyst performs a test to directly measure small dense low–density lipoprotein (LDL) cholesterol in a patient specimen. This is a clinical chemistry or specialized lipid testing service used to quantify the concentration of small dense LDL particles, a component of advanced lipid profiling.
Service Type: Specialized laboratory diagnostic test — direct measurement of small dense LDL cholesterol
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 56-year-old male with a history of hyperlipidemia and premature coronary artery disease presents for lipid risk stratification after a routine fasting lipid panel shows borderline elevated LDL-C despite statin therapy. The clinician orders a direct measurement of small dense LDL cholesterol to assess residual atherogenic particle burden and refine secondary prevention planning. A phlebotomy draw is performed in an outpatient laboratory or hospital ambulatory clinic; the specimen is labeled and transported to the clinical chemistry or lipid reference laboratory. The lab analyst performs the 83722 assay using the site's validated direct small dense LDL-C method and documents the result in the laboratory information system. Results are reported back to the ordering provider and incorporated into the patient’s risk assessment and medication management plan. Typical sites of service: outpatient clinic, independent diagnostic laboratory, hospital outpatient lab, or ambulatory surgical center when part of an extended cardiovascular workup.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional interpretation or physician oversight for the test separate from the technical component. |