ICD-10 Coding for Abnormal Cholesterol Level(E78.00, E78.2, E78.5)
Complete ICD-10-CM coding and documentation guide for Abnormal Cholesterol Level. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Abnormal Cholesterol Level
E78.0-E78.5Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes codes for various types of hyperlipidemia, including hypercholesterolemia and mixed hyperlipidemia.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E78.00 | Pure hypercholesterolemia, unspecified | Use when managing cholesterol-specific therapy with LDL-C ≥190 mg/dL. |
|
| E78.2 | Mixed hyperlipidemia | Use when both LDL and triglycerides are elevated and documented. |
|
| E78.5 | Unspecified hyperlipidemia | Use when specific type of hyperlipidemia is not documented. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for abnormal cholesterol levels
Essential facts and insights about Abnormal Cholesterol Level
Primary ICD-10-CM Codes for abnormal cholesterol level
Decision Criteria
clinical Criteria
- LDL-C ≥190 mg/dL confirmed on two separate occasions.
Applicable To
- Primary hypercholesterolemia
Excludes
- Familial hypercholesterolemia (E78.01)
Clinical Validation Requirements
- LDL-C ≥190 mg/dL without elevated triglycerides or secondary causes
Code-Specific Risks
- Incorrect use if triglycerides are elevated.
Coding Notes
- Ensure LDL-C levels are documented and secondary causes are ruled out.
E78.2 - Mixed hyperlipidemia
Use when both LDL and triglycerides are elevated and documented.
Applicable To
- Hyperlipidemia with both high LDL and triglycerides
Clinical Validation Requirements
- LDL-C ≥160 mg/dL and triglycerides ≥150 mg/dL
Coding Notes
Document both LDL and triglyceride levels.
E78.5 - Unspecified hyperlipidemia
Use when specific type of hyperlipidemia is not documented.
Clinical Validation Requirements
- Abnormal lipid panel without specific type documented
Coding Notes
Ensure no specific lipid type is documented before using.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Familial hypercholesterolemia
E78.01Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Abnormal Cholesterol Level to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E78.00.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Potential audit issues., Financial: Risk of claim denials.
Mitigation Strategy
Review lab results for specific lipid abnormalities., Consult with the provider for clarification if needed.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and statistics.
Mitigation Strategy
Ensure both LDL and triglyceride levels meet criteria before coding E78.2.
Impact
Frequent use of E78.5 without specific lipid documentation.
Mitigation Strategy
Implement EHR alerts for specific lipid documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Abnormal Cholesterol Level, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Abnormal Cholesterol Level
Use these documentation templates to ensure complete and accurate documentation for Abnormal Cholesterol Level. These templates include all required elements for proper coding and billing.
Cholesterol management follow-up
Specialty: CardiologyRequired Elements
- Patient history
- Lipid panel results
- Treatment plan
- Provider signature
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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