According to National Government Services (NGS) providers have been inappropriately billing a Lipid Panel (CPT code 80061) and a Lipoprotein (CPT code 83721) test for the same patient on the same date of service.

According to the Local Coverage Determination (LCD) for Lipid Profile/Cholesterol Testing, it is not medically necessary to perform these tests on the same day unless the triglyceride level exceeds 400 mg/dl. It is inappropriate to bill CPT code 80061 and 83721 (with modifier -59) to get the claim paid unless the lipoprotein test is medically necessary (determined by the triglyceride level).

This notice was recently published on the NGS website.