ICD-10 Coding for Abnormal Lipid Panel(E78.0, E78.2, E78.5)
Complete ICD-10-CM coding and documentation guide for Abnormal Lipid Panel. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Abnormal Lipid Panel
E78.0-E78.5Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes codes for various types of lipid disorders, including hypercholesterolemia and mixed hyperlipidemia.
Encounter for screening for lipoid disorders
Used for screening purposes when no symptoms or diagnosis of lipid disorder is present.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E78.0 | Pure hypercholesterolemia | Use when LDL levels are ≥190 mg/dL and familial hypercholesterolemia is confirmed. |
|
| E78.2 | Mixed hyperlipidemia | Use when both LDL and triglycerides are elevated. |
|
| E78.5 | Hyperlipidemia, unspecified | Use when specific lipid disorder classification is not possible. |
|
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 lipid panel
Essential facts and insights about Abnormal Lipid Panel
Primary ICD-10-CM Codes for abnormal lipid panel
Decision Criteria
clinical Criteria
- LDL cholesterol ≥190 mg/dL
Applicable To
- Familial hypercholesterolemia
Excludes
- Hyperlipidemia, unspecified (E78.5)
Clinical Validation Requirements
- LDL cholesterol ≥190 mg/dL
- Documented familial history
Code-Specific Risks
- Misclassification if LDL levels are not documented
Coding Notes
- Ensure LDL levels are documented to avoid misclassification.
E78.2 - Mixed hyperlipidemia
Use when both LDL and triglycerides are elevated.
Applicable To
- Combined hyperlipidemia
Excludes
- Pure hypercholesterolemia (E78.0)
Clinical Validation Requirements
- Elevated LDL and triglycerides
Coding Notes
Ensure both LDL and triglycerides are documented.
E78.5 - Hyperlipidemia, unspecified
Use when specific lipid disorder classification is not possible.
Excludes
- Specific types of hyperlipidemia (E78.0-E78.4)
Clinical Validation Requirements
- General lipid panel results without specific classification
Coding Notes
Avoid using E78.5 when specific lipid levels are known.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Screening for lipoid disorders
Z13.220Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Abnormal Lipid Panel to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E78.0.
Impact
Clinical: May lead to inappropriate treatment decisions, Regulatory: Non-compliance with documentation standards, Financial: Potential for claim denials
Mitigation Strategy
Always include the clinical indication for testing, Use templates that prompt for this information
Impact
Reimbursement: May lead to denials or reduced reimbursement, Compliance: Non-compliance with coding guidelines, Data Quality: Poor data quality and inaccurate patient records
Mitigation Strategy
Ensure specific lipid levels are documented and use the appropriate specific code.
Impact
High risk of audit if unspecified codes are used when specific lipid levels are documented.
Mitigation Strategy
Ensure documentation of specific lipid levels and use the most specific code available.
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 Lipid Panel, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Abnormal Lipid Panel
Use these documentation templates to ensure complete and accurate documentation for Abnormal Lipid Panel. These templates include all required elements for proper coding and billing.
Primary Care Visit for Lipid Panel Evaluation
Specialty: Primary CareRequired Elements
- Patient history
- Lipid panel results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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