Summary & Overview
HCPCS G8767: Lipid Panel Results Documented and Reviewed
HCPCS Level II code G8767 represents documentation and clinical review of a complete lipid panel — specifically total cholesterol, HDL-C, triglycerides and calculated LDL-C. This code captures the act of recording laboratory lipid results in the medical record and confirming clinician review, a step that supports cardiovascular risk management and quality measurement. Nationally, consistent documentation of lipid results informs population health efforts, chronic disease management, and preventive care performance metrics.
Key payers considered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise briefing on what the code denotes clinically and operationally, typical sites where it is used, and the importance of recording comprehensive lipid data for care coordination and quality reporting. The publication outlines benchmarks and policy implications where available, highlights clinical context for use in primary care and specialty settings, and summarizes areas where additional coding guidance or payer-specific coverage rules may affect billing and documentation. Data not provided in the input (such as specific modifiers, taxonomies, ICD-10 pairings, and payer-specific rules) are noted as unavailable.
Billing Code Overview
HCPCS Level II code G8767 documents that lipid panel results were both documented and reviewed. The required components include total cholesterol, HDL-C, triglycerides, and calculated LDL-C, indicating the clinical focus on a comprehensive lipid assessment.
Service Type: Laboratory result documentation and clinical review
Typical Site of Service: Outpatient clinic or ambulatory care setting where laboratory results are reviewed and recorded, including primary care offices, cardiology clinics, and preventive medicine visits.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a history of hypertension and type 2 diabetes presents to a primary care clinic for routine chronic disease management. As part of cardiovascular risk assessment and lipid management, blood is drawn for a fasting lipid panel that must include total cholesterol, HDL-C, triglycerides, and calculated LDL-C. Laboratory results are uploaded to the electronic health record and the ordering clinician reviews and documents the results during the visit, noting whether values are at goal, whether therapy adjustments are needed, and scheduling follow-up. Typical workflow: order test during visit or at standing lab appointment, specimen collection at outpatient laboratory or clinic phlebotomy, laboratory analysis, results routed to clinician inbox, clinician reviews results, documents review in the chart, and communicates pertinent findings to the patient via portal message or during a follow-up visit.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure | Use when an E/M visit is performed and documented in addition to reviewing and documenting the lipid panel results |
59 | Distinct procedural service |