Ordering tests for C-reactive Protein (CRP)

Main Line Health Laboratories offers two different tests that measure the same molecule in serum – C-Reactive Protein (CRP) and high-sensitivity C-Reactive Protein (hsCRP).  These tests have very different clinical indications (ICD-9 codes), methods of reporting and interpretation, CPT codes, and reimbursement rates.  Please be sure to choose the correct test that is desired: 

• C-Reactive Protein (CPT code 86140) has been used for decades as a measure of inflammation (acute phase reactant), somewhat analogous to Erythrocyte Sedimentation Rate.  Results are presented with a reference (normal) range; abnormal values are increased out of the normal range.  Please order as “CRP”.  The results for this test have been placed in the general chemistry section in SmartChart.
  
  
• High sensitivity C-Reactive Protein (CPT code 86141) is a test developed in the last few years as a measure of cardiovascular risk.  As the name implies, hsCRP is more sensitive than the older CRP test, based on the finding that even “normal” levels of C-Reactive Protein may indicate increased risk of cardiovascular events if the levels are at the higher end of the normal range, presumably reflecting low-level inflammation that contributes to progression of atherosclerosis.  Results for hsCRP are grouped into thirds (tertiles) within the normal range, with the highest tertile indicating the most risk.  Please order as “hsCRP”.  The results for this test have been placed in the cardiac marker section in SmartChart.

Please note that if a test is ordered as “CRP”, the older, less sensitive test for inflammation will be reported that is not useful as a cardiovascular risk marker.

If you have further questions, please feel free to contact Albert Keshgegian, MD PhD, Medical Director, at 484-476-3552.  Thank you for your support of Main Line Health Laboratories.