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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:

High CholesterolHypercholesterolemia

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

CodeDescriptionWhen to UseKey Documentation
E78.00Pure hypercholesterolemia, unspecifiedUse when LDL is ≥190 mg/dL without secondary causes or mixed lipid abnormalities.
  • LDL ≥190 mg/dL
  • Exclusion of secondary causes such as hypothyroidism
E78.01Familial hypercholesterolemiaUse when there is genetic confirmation or family history of premature cardiovascular disease.
  • LDL ≥190 mg/dL
  • Family history of premature cardiovascular disease
  • Genetic testing results if available
E78.2Mixed hyperlipidemiaUse when both LDL and triglycerides are elevated.
  • LDL ≥160 mg/dL
  • Triglycerides ≥200 mg/dL

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

The ICD-10 code for unspecified pure hypercholesterolemia is E78.00, used when LDL is ≥190 mg/dL without secondary causes.

Primary ICD-10-CM Codes for abnormal total cholesterol

Pure hypercholesterolemia, unspecified
Billable Code

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

Excludes

  • Familial hypercholesterolemia (E78.01)
  • Mixed hyperlipidemia (E78.2)

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.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Screening for lipid disorder

Z13.220
Use for asymptomatic patients undergoing routine lipid panel screening.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Familial hypercholesterolemia

E78.01
Requires genetic confirmation or family history of premature cardiovascular disease.

Mixed hyperlipidemia

E78.2
Use when both LDL and triglycerides are elevated.

Pure hypercholesterolemia, unspecified

E78.00
Use when there is no family history or genetic confirmation.

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 Medicine

Required Elements

  • Patient symptoms
  • Family history
  • Physical exam findings
  • Lab results
  • Assessment and plan

Example Documentation

**Subjective**: Patient reports no symptoms. Family history of premature CVD. **Objective**: BMI: 25. Physical exam: No xanthomas. Labs: LDL 210 mg/dL. **Assessment**: Pure hypercholesterolemia, unspecified (E78.00). **Plan**: Start atorvastatin 20 mg daily. Repeat lipids in 12 weeks.

Examples: Poor vs. Good Documentation

Poor Documentation Example
High cholesterol, start statin.
Good Documentation Example
Pure hypercholesterolemia, unspecified (LDL 210 mg/dL). No secondary causes identified. Start atorvastatin 20 mg daily. Repeat lipids in 12 weeks.
Explanation
The good example provides specific LDL levels and excludes secondary causes, supporting the code choice.

Need help with ICD-10 coding for Abnormal Total Cholesterol? Ask your questions below.

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