ICD-10 Coding for Elevated Cholesterol Level(E78.00, E78.01, E78.2)
Complete ICD-10-CM coding and documentation guide for Elevated Cholesterol Level. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Elevated Cholesterol Level
E78.0-E78.5Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes codes for different 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 elevated but triglycerides are normal. |
|
| E78.01 | Familial hypercholesterolemia | Use when familial hypercholesterolemia is confirmed by genetic testing or family history. |
|
| 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 elevated cholesterol
Essential facts and insights about Elevated Cholesterol Level
Primary ICD-10-CM Codes for elevated cholesterol level
Decision Criteria
clinical Criteria
- LDL ≥190 mg/dL without elevated triglycerides
Applicable To
- Isolated elevated LDL
Excludes
- Hyperlipidemia, unspecified (E78.5)
Clinical Validation Requirements
- LDL ≥190 mg/dL without elevated triglycerides
Code-Specific Risks
- Using this code without specifying LDL levels can lead to denials.
Coding Notes
- Ensure LDL levels are documented to support this code.
E78.01 - Familial hypercholesterolemia
Use when familial hypercholesterolemia is confirmed by genetic testing or family history.
Applicable To
- Genetic hypercholesterolemia
Clinical Validation Requirements
- LDL ≥190 mg/dL with family history or genetic confirmation
Coding Notes
Document genetic testing results or family history.
E78.2 - Mixed hyperlipidemia
Use when both LDL and triglycerides are elevated.
Applicable To
- Elevated LDL and triglycerides
Clinical Validation Requirements
- LDL ≥160 mg/dL and triglycerides ≥175 mg/dL
Coding Notes
Document both LDL and triglyceride levels.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Atherosclerosis of coronary artery without angina
I25.10Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Elevated 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 decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always document specific lipid levels., Use specific codes when lipid levels are known.
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases specificity of health data.
Mitigation Strategy
Use specific codes like E78.00 or E78.2 when lipid levels are known.
Impact
Using E78.5 when specific lipid levels are documented.
Mitigation Strategy
Ensure specific lipid levels are documented and use specific codes.
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 Elevated Cholesterol Level, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Elevated Cholesterol Level
Use these documentation templates to ensure complete and accurate documentation for Elevated Cholesterol Level. These templates include all required elements for proper coding and billing.
Primary Care Visit for Hyperlipidemia
Specialty: Primary CareRequired Elements
- Lipid panel results
- Family history
- Physical examination findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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