ICD-10 Coding for Elevated Lipids(E78.0, E78.1, E78.2, E78.5)
Complete ICD-10-CM coding and documentation guide for Elevated Lipids. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Elevated Lipids
E78.0-E78.5Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes all primary codes for elevated lipids, covering specific and unspecified types.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E78.0 | Pure hypercholesterolemia | Use when LDL is ≥190 mg/dL without elevated triglycerides. |
|
| E78.1 | Pure hyperglyceridemia | Use when triglycerides are ≥200 mg/dL without elevated LDL. |
|
| E78.2 | Mixed hyperlipidemia | Use when both LDL and triglycerides are elevated. |
|
| E78.5 | Hyperlipidemia, unspecified | Use when lipid type cannot be determined from documentation. |
|
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 lipids
Essential facts and insights about Elevated Lipids
Primary ICD-10-CM Codes for elevated lipid
Decision Criteria
clinical Criteria
- LDL ≥190 mg/dL
Applicable To
- Isolated elevated LDL
Excludes
- Hyperlipidemia, unspecified (E78.5)
Clinical Validation Requirements
- LDL ≥190 mg/dL
- Fasting lipid panel
Code-Specific Risks
- Misclassification if triglycerides are also elevated.
Coding Notes
- Ensure LDL levels are documented and meet the threshold.
E78.1 - Pure hyperglyceridemia
Use when triglycerides are ≥200 mg/dL without elevated LDL.
Applicable To
- Isolated elevated triglycerides
Excludes
- Mixed hyperlipidemia (E78.2)
Clinical Validation Requirements
- Triglycerides ≥200 mg/dL
- Fasting triglycerides
Coding Notes
Ensure triglyceride levels are documented and meet the threshold.
E78.2 - Mixed hyperlipidemia
Use when both LDL and triglycerides are elevated.
Applicable To
- Elevated LDL and triglycerides
Excludes
- Pure hypercholesterolemia (E78.0)
- Pure hyperglyceridemia (E78.1)
Clinical Validation Requirements
- LDL ≥160 mg/dL and triglycerides ≥150 mg/dL
- Fasting lipid panel
Coding Notes
Document both LDL and triglyceride levels clearly.
E78.5 - Hyperlipidemia, unspecified
Use when lipid type cannot be determined from documentation.
Applicable To
- Unspecified lipid elevation
Excludes
- Specific types of hyperlipidemia (E78.0-E78.2)
Clinical Validation Requirements
- Lack of specific lipid type documentation
Coding Notes
Query provider for clarification if possible.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Atherosclerosis of native coronary artery without angina pectoris
I25.10Differential 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 Elevated Lipids to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E78.0.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Increases audit risk., Financial: Potential claim denials.
Mitigation Strategy
Always specify lipid types and levels., Use standardized templates.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Confirm triglycerides are also elevated before using E78.2.
Impact
Using E78.5 without attempting to specify lipid type.
Mitigation Strategy
Query providers for specific lipid levels.
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 Lipids, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Elevated Lipids
Use these documentation templates to ensure complete and accurate documentation for Elevated Lipids. These templates include all required elements for proper coding and billing.
Cardiology follow-up for hyperlipidemia
Specialty: CardiologyRequired Elements
- Fasting lipid panel results
- Assessment of lipid levels
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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