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Elevated Lp(a)*
screening requires
only a simple-to-order
blood test1
An Lp(a) test can be added to any
routine blood work
*Elevated Lp(a) levels defined as ≥50 mg/dL or ≥125 nmol/L.
Because Lp(a) levels are established at a young age, ordering an elevated Lp(a) test can inform a lifetime of cardiovascular risk management2
2024 billable ICD-10-CM diagnosis codes3
- Elevated Lp(a): E78.41
- Family history of elevated Lp(a): Z83.430
CPT code4
- Elevated Lp(a): 83695
Lp(a) levels may be reported in mg/dL or nmol/L; either can be used to assess risk2,5,6
Elevated Lp(a) (increased cardiovascular risk): ≥50 mg/dL (≥125 nmol/L)5
Borderline cardiovascular risk: 30 mg/dL (75 nmol/L) to 50 mg/dL (125 nmol/L)2
Normal: <30 mg/dL (75 nmol/L)2,6
Lp(a) levels <3 mg/dL (7.5 nmol/L) to 5 mg/dL (12.5 nmol/L) may be associated with an increased risk of incident type 2 diabetes mellitus2,7
The AACE/ACE suggests elevated Lp(a) screening for a broad range of patients8
2020 AACE/ACE consensus statement suggests elevated Lp(a) screening for the following people:
All patients with clinical atherosclerotic cardiovascular disease (ASCVD), especially premature or recurrent ASCVD despite LDL lowering
All patients with a personal or family history of aortic valve stenosis
All individuals of South Asian or African ancestry, especially those with a family history of ASCVD or increased Lp(a)
All patients with a family history of premature ASCVD and/or elevated Lp(a)
All Individuals with a 10-year ASCVD risk ≥10% in the primary prevention setting, to stratify risk
Patients with refractory elevations of LDL-C despite aggressive LDL-C lowering therapy
The NLA recommends considering an Lp(a) test for all adults9
A 2024 update to the NLA Scientific Statement on Use of Lp(a) in Clinical Practice recommends considering Lp(a) testing at least once in every adult for cardiovascular risk stratification9
Cascade screening of first-degree relatives of patients with elevated Lp(a) is also recommended to identify additional individuals at risk9
High-risk patients should consider receiving early, more intensive risk factor management, including lifestyle modification and lipid-lowering drug therapy to reduce low-density lipoprotein cholesterol (LDL-C) levels9
There are several ways you can help improve the outcomes of your patients with elevated Lp(a).
ICD-10=International Classification of Diseases, Tenth Revision; CPT=Current Procedural Terminology.
References: 1. Farzam K, Senthilkumaran S. Lipoprotein A. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Updated September 2, 2022. Accessed August 22, 2023. https://www.statpearls.com/ArticleLibrary/viewarticle/130795 2. Kronenberg F, Mora S, Stroes ESG, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J. 2022;14:43(39):3925-3946. 3. Engler RJM, Brede E, Villines T, Vernalis MN. Lipoprotein(a) elevation: A new diagnostic code with relevance to service members and veterans. Fed Pract. 2019;36(Suppl 7):S19-S31. 4. Quest Diagnostics. Lipoprotein (a). Accessed August 22, 2023. https://testdirectory.questdiagnostics.com/test/test-detail/34604/lipoprotein-a?cc=MASTER 5. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;10;140(11):e596-e646. 6. Tsimikas S. A test in context: Lipoprotein(a): Diagnosis, prognosis, controversies, and emerging therapies. J Am Coll Cardiol. 2017;69(6):692-711. 7. Tsimikas S. In search of a physiological function of lipoprotein(a): causality of elevated Lp(a) levels and reduced incidence of type 2 diabetes. J Lipid Res. 2018;59(5):741-744. 8. Handelsman Y, Jellinger PS, Guerin CK, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the management of dyslipidemia and prevention of cardiovascular disease algorithm - 2020 Executive Summary. Endocr Pract. 2020;26(10):1196-1224. 9. Koschinsky ML, Bajaj A, Boffa MB, et al. A focused update to the 2019 NLA scientific statement on use of lipoprotein(a) in clinical practice. J Clin Lipidol. Published online March 29, 2024. doi:10.1016/ j.jacl.2024.03.001