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ICD-10 Coding for Dyslipidemia(E78.0, E78.2, E78.5)

Complete ICD-10-CM coding and documentation guide for Dyslipidemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

HyperlipidemiaHypercholesterolemiaMixed Hyperlipidemiahypertriglyceridemia

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Related ICD-10 Code Ranges

Complete code families applicable to Dyslipidemia

E78.0-E78.5Primary Range

Disorders of lipoprotein metabolism and other lipidemias

This range includes all primary codes for dyslipidemia, covering various types of lipid disorders.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
E78.0Pure hypercholesterolemiaUse when LDL-C is ≥190 mg/dL without elevated triglycerides.
  • LDL-C ≥190 mg/dL
  • Family history of hypercholesterolemia
E78.2Mixed hyperlipidemiaUse when both LDL-C and triglycerides are elevated.
  • LDL-C ≥160 mg/dL
  • Triglycerides ≥200 mg/dL
E78.5Unspecified hyperlipidemiaUse when lipid levels are not specified or documented.
  • Lipid levels not specified

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 dyslipidemia

Essential facts and insights about Dyslipidemia

The ICD-10 code for dyslipidemia includes E78.0 for pure hypercholesterolemia, E78.2 for mixed hyperlipidemia, and E78.5 for unspecified hyperlipidemia.

Primary ICD-10-CM Codes for dyslipidemia

E78.0
Pure hypercholesterolemia
Non-billable Code

Decision Criteria

clinical Criteria

  • LDL-C ≥190 mg/dL

documentation Criteria

  • Document familial history if present.

Applicable To

  • Familial hypercholesterolemia

Excludes

  • Mixed hyperlipidemia (E78.2)

Clinical Validation Requirements

  • LDL-C ≥190 mg/dL
  • Family history of hypercholesterolemia

Code-Specific Risks

  • Misclassification if triglycerides are also elevated.

Coding Notes

  • Ensure LDL-C levels are documented and familial history is noted if applicable.
View Full Code Details

Ancillary Codes

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

Long-term (current) use of lipid-lowering agents

Z79.4
Use when the patient is on long-term statin therapy.

Differential Codes

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

Mixed hyperlipidemia

E78.2
Use E78.2 if both LDL-C and triglycerides are elevated.

Pure hypercholesterolemia

E78.0
Use E78.0 if only LDL-C is elevated.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Dyslipidemia 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 plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.

Mitigation Strategy

Always ask about family history during patient intake., Include family history in the patient's medical record.

Impact

Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with specificity requirements., Data Quality: Decreases accuracy of patient records.

Mitigation Strategy

Use E78.0 or E78.2 based on specific LDL-C and triglyceride levels.

Impact

Audits may focus on the specificity of documented lipid levels.

Mitigation Strategy

Ensure all lipid levels are documented and coded accurately.

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 Dyslipidemia, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Dyslipidemia

Use these documentation templates to ensure complete and accurate documentation for Dyslipidemia. These templates include all required elements for proper coding and billing.

Management of Dyslipidemia in Cardiology

Specialty: Cardiology

Required Elements

  • Lipid profile results
  • ASCVD risk score
  • Family history
  • Treatment plan

Example Documentation

Patient presents with LDL 210 mg/dL, HDL 45 mg/dL. ASCVD risk 15%. Family history positive for hypercholesterolemia. Plan: Initiate atorvastatin 20mg.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has high cholesterol.
Good Documentation Example
Patient diagnosed with pure hypercholesterolemia, LDL 210 mg/dL, family history positive.
Explanation
The good example provides specific lipid levels and family history, supporting the diagnosis.

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