ICD-10 Coding for Abnormal Total Cholesterol(E78.00, E78.01, E78.2)
Complete ICD-10-CM coding and documentation guide for Abnormal Total Cholesterol. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Abnormal Total Cholesterol
E78.0-E78.9Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes codes for various types of hyperlipidemia, including pure 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 LDL is ≥190 mg/dL without secondary causes or mixed lipid abnormalities. |
|
| E78.01 | Familial hypercholesterolemia | Use when there is genetic confirmation or family history of premature cardiovascular disease. |
|
| E78.2 | Mixed hyperlipidemia | Use when both LDL and triglycerides are elevated. |
|
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 total cholesterol
Essential facts and insights about Abnormal Total Cholesterol
Primary ICD-10-CM Codes for abnormal total cholesterol
Decision Criteria
clinical Criteria
- LDL ≥190 mg/dL without secondary causes
documentation Criteria
- Document LDL levels and exclusion of secondary causes
Applicable To
- Unspecified pure hypercholesterolemia
Clinical Validation Requirements
- LDL ≥190 mg/dL
- Exclusion of secondary causes such as hypothyroidism
Code-Specific Risks
- Using without supporting LDL levels may trigger audits.
Coding Notes
- Ensure LDL levels and exclusion of secondary causes are documented.
E78.01 - Familial hypercholesterolemia
Use when there is genetic confirmation or family history of premature cardiovascular disease.
Applicable To
- Genetically confirmed familial hypercholesterolemia
Excludes
- Pure hypercholesterolemia, unspecified (E78.00)
Clinical Validation Requirements
- LDL ≥190 mg/dL
- Family history of premature cardiovascular disease
- Genetic testing results if available
Coding Notes
Document family history and genetic testing results.
E78.2 - Mixed hyperlipidemia
Use when both LDL and triglycerides are elevated.
Applicable To
- Elevated LDL and triglycerides
Excludes
- Pure hypercholesterolemia (E78.00)
- Familial hypercholesterolemia (E78.01)
Clinical Validation Requirements
- LDL ≥160 mg/dL
- Triglycerides ≥200 mg/dL
Coding Notes
Ensure both LDL and triglyceride levels are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Screening for lipid disorder
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 Total Cholesterol to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E78.00.
Impact
Clinical: Misrepresents the patient's condition., Regulatory: Non-compliance with coding guidelines., Financial: Potential loss of reimbursement opportunities.
Mitigation Strategy
Verify family history and genetic testing results, Use E78.01 when familial hypercholesterolemia is confirmed
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement., Compliance: May result in non-compliance with coding guidelines., Data Quality: Affects the accuracy of patient records.
Mitigation Strategy
Use E78.2 if triglycerides are ≥200 mg/dL.
Impact
Reimbursement: Lack of documentation can lead to claim denials., Compliance: Non-compliance with documentation standards., Data Quality: Leads to incomplete patient records.
Mitigation Strategy
Document TSH, creatinine, and alcohol use.
Impact
High risk of audit if LDL levels and secondary causes are not documented.
Mitigation Strategy
Ensure complete documentation of lab results and exclusion of secondary causes.
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 Total Cholesterol, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Abnormal Total Cholesterol
Use these documentation templates to ensure complete and accurate documentation for Abnormal Total Cholesterol. These templates include all required elements for proper coding and billing.
Primary Care Progress Note
Specialty: Internal MedicineRequired Elements
- Patient symptoms
- Family history
- Physical exam findings
- Lab results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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