ICD-10 Coding for Elevated Cholesterol(E78.00, E78.2)
Complete ICD-10-CM coding and documentation guide for Elevated Cholesterol. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Elevated Cholesterol
E78.0-E78.5Primary 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 elevated without elevated triglycerides. |
|
| 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
Primary ICD-10-CM Codes for elevated cholesterol
Decision Criteria
clinical Criteria
- LDL ≥190 mg/dL without elevated triglycerides.
Applicable To
- Isolated LDL elevation
Excludes
- Mixed hyperlipidemia (E78.2)
Clinical Validation Requirements
- LDL ≥190 mg/dL
- Two fasting panels 2-12 weeks apart
Code-Specific Risks
- Misclassification if triglycerides are also elevated.
Coding Notes
- Ensure LDL levels are documented to support code selection.
E78.2 - Mixed hyperlipidemia
Use when both LDL and triglycerides are elevated.
Applicable To
- Combined elevation of LDL and triglycerides
Excludes
- Pure hypercholesterolemia (E78.00)
Clinical Validation Requirements
- LDL ≥160 mg/dL
- Triglycerides ≥200 mg/dL
Coding Notes
Document both LDL and triglyceride levels to support code selection.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of statins
Z79.52Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Elevated 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: May affect treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always document fasting status with lipid panels.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Verify triglyceride levels before coding.
Impact
Using incorrect codes for lipid panels can trigger audits.
Mitigation Strategy
Verify all lipid components are tested and documented.
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, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Elevated Cholesterol
Use these documentation templates to ensure complete and accurate documentation for Elevated Cholesterol. These templates include all required elements for proper coding and billing.
Routine Check-up with Elevated Cholesterol
Specialty: Primary CareRequired Elements
- Patient history
- Lipid panel results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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