ICD-10 Coding for High Cholesterol Unspecified(E78.00)
Complete ICD-10-CM coding and documentation guide for High Cholesterol Unspecified. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to High Cholesterol Unspecified
E78.0-E78.5Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes codes for various types of hyperlipidemia, with E78.00 specifically for unspecified hypercholesterolemia.
Key Information: ICD-10 code for high cholesterol unspecified
Essential facts and insights about High Cholesterol Unspecified
Primary ICD-10-CM Code for high cholesterol unspecified
Decision Criteria
clinical Criteria
- LDL cholesterol ≥160 mg/dL and total cholesterol ≥200 mg/dL
documentation Criteria
- Exclusion of secondary causes such as diabetes or hypothyroidism
Applicable To
- Isolated elevation of LDL cholesterol
Clinical Validation Requirements
- LDL cholesterol ≥160 mg/dL
- Total cholesterol ≥200 mg/dL
- Exclusion of secondary causes
Code-Specific Risks
- Risk of undercoding if secondary causes are not ruled out.
- Potential audit if documentation is insufficient.
Coding Notes
- Ensure documentation explicitly states 'pure hypercholesterolemia, unspecified' and includes lab results.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Atherosclerotic heart disease 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 High Cholesterol Unspecified 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., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always review patient history for secondary causes., Document normal TSH and absence of diabetes.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use E78.2 for mixed hyperlipidemia if triglycerides are also elevated.
Impact
High risk of audit if unspecified codes are used without proper documentation.
Mitigation Strategy
Ensure all documentation supports the use of E78.00 and excludes 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 High Cholesterol Unspecified, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for High Cholesterol Unspecified
Use these documentation templates to ensure complete and accurate documentation for High Cholesterol Unspecified. These templates include all required elements for proper coding and billing.
Primary Care Progress Note
Specialty: Internal MedicineRequired Elements
- Diagnosis statement
- Lipid panel results
- Exclusion of secondary causes
- Treatment plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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