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The CPT® Code 83698 refers to a laboratory test that measures lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme that serves as an inflammatory risk marker for cardiovascular disease. Lp-PLA2 is found circulating in the bloodstream and is known to attach to low-density lipoprotein (LDL) cholesterol particles. When these LDL particles adhere to the walls of arteries, they undergo oxidation, leading to the formation of oxidized LDL. This oxidized form is particularly vulnerable to enzymatic degradation, which in turn promotes the release of inflammatory molecules. These molecules play a significant role in the atherosclerotic process, contributing to the accumulation of fatty deposits, or plaque, within the arterial walls. Furthermore, Lp-PLA2 has the ability to attract and bind monocytes, a type of large white blood cell that can differentiate into macrophages, further exacerbating plaque build-up. Research indicates that inflammation is a critical factor in the development of cardiovascular disease, and Lp-PLA2 is increasingly recognized as a valuable risk marker due to its association with the atherosclerotic process. Elevated levels of Lp-PLA2 have been correlated with an increased risk of future cardiovascular events, independent of other traditional risk factors. The measurement of Lp-PLA2 is performed through a straightforward blood test utilizing the enzyme-linked immunosorbent assay (ELISA) technique, commonly referred to as the PLAC test. The results are reported in nanograms per milliliter (ng/mL), with average values typically being 174 ng/mL for females and 251 ng/mL for males.
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The Lp-PLA2 test is indicated for assessing the risk of cardiovascular disease, particularly in individuals who may be at an increased risk due to various factors. The following conditions and symptoms may warrant the use of this test:
The procedure for measuring lipoprotein-associated phospholipase A2 (Lp-PLA2) involves several key steps to ensure accurate results. First, a healthcare professional will collect a blood sample from the patient, typically through venipuncture, where a needle is inserted into a vein, usually in the arm. This blood sample is then processed in a laboratory setting. The laboratory technician will utilize the enzyme-linked immunosorbent assay (ELISA) technique, which is a common method for detecting and quantifying proteins in a sample. During this process, the blood sample is treated with specific antibodies that bind to Lp-PLA2, allowing for its measurement. The results are quantified in nanograms per milliliter (ng/mL), providing a clear indication of the enzyme's concentration in the bloodstream. The test is often referred to as the PLAC test, and the results can help healthcare providers assess the patient's risk for cardiovascular events based on the levels of Lp-PLA2 detected.
After the Lp-PLA2 test is completed, there are generally no specific post-procedure care requirements for the patient, as the blood draw is a routine procedure. Patients may resume their normal activities immediately following the test. However, it is advisable for patients to await the results, which will be communicated by their healthcare provider. The interpretation of the results will depend on the levels of Lp-PLA2 detected, and the healthcare provider may discuss the implications of these results in the context of the patient's overall cardiovascular risk profile. If elevated levels are found, further evaluation or intervention may be recommended based on the patient's individual health status and risk factors.
| Short Descr | ASSAY LIPOPROTEIN PLA2 | Medium Descr | LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2 | Long Descr | Lipoprotein-associated phospholipase A2 (Lp-PLA2) | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 233 - Laboratory - Chemistry and Hematology |
| 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | GZ | Item or service expected to be denied as not reasonable and necessary | GA | Waiver of liability statement issued as required by payer policy, individual case | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | Q4 | Service for ordering/referring physician qualifies as a service exemption |
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| 2022-01-01 | Changed | AMA guideline removed. |
| 2017-01-01 | Changed | Guideline added. |
| 2008-01-01 | Changed | Code description changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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