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ICD-10 Coding for Hyperlipoproteinemia(E78.0, E78.1, E78.2, E78.3, E78.5)

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

Also known as:

HLPLipid Disorder

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Related ICD-10 Code Ranges

Complete code families applicable to Hyperlipoproteinemia

E78.0-E78.5Primary Range

Disorders of lipoprotein metabolism and other lipidemias

This range includes all primary types of hyperlipoproteinemia, covering pure hypercholesterolemia, hypertriglyceridemia, mixed hyperlipidemia, and unspecified types.

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 cholesterol is elevated above 190 mg/dL, especially with familial history.
  • LDL >190 mg/dL
  • Genetic testing for familial hypercholesterolemia
E78.1Pure hyperglyceridemiaUse when triglyceride levels exceed 500 mg/dL.
  • Triglycerides >500 mg/dL
E78.2Mixed hyperlipidemiaUse when both LDL and triglycerides are elevated.
  • LDL >160 mg/dL and triglycerides >200 mg/dL
E78.3HyperchylomicronemiaUse when chylomicrons are present with very high triglycerides.
  • Presence of chylomicrons and triglycerides >1,000 mg/dL
E78.5Unspecified hyperlipidemiaUse only when specific lipid abnormalities are not documented.
  • Lack of specific lipid abnormality 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 mixed hyperlipidemia

Essential facts and insights about Hyperlipoproteinemia

The ICD-10 code for mixed hyperlipidemia is E78.2, used when both LDL and triglyceride levels are elevated.

Primary ICD-10-CM Codes for hyperlipoproteinemia

E78.0
Pure hypercholesterolemia
Non-billable Code

Decision Criteria

clinical Criteria

  • LDL cholesterol >190 mg/dL

documentation Criteria

  • Family history of hypercholesterolemia

Applicable To

  • Familial hypercholesterolemia

Excludes

  • Secondary hypercholesterolemia due to hypothyroidism (E03.9)

Clinical Validation Requirements

  • LDL >190 mg/dL
  • Genetic testing for familial hypercholesterolemia

Code-Specific Risks

  • Misclassification without genetic confirmation

Coding Notes

  • Ensure LDL levels are documented and consider genetic testing for familial cases.
View Full Code Details

Ancillary Codes

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

Atherosclerotic heart disease

I25.10
Use when hypercholesterolemia is associated with coronary artery disease.

Acute pancreatitis

K85.9
Use when hyperglyceridemia leads to pancreatitis.

Acute myocardial infarction

I21.9
Use when mixed hyperlipidemia is associated with cardiac events.

Fat malabsorption

K90.0
Use when hyperchylomicronemia is associated with malabsorption.

Differential Codes

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

Unspecified hyperlipidemia

E78.5
Use E78.5 only when specific lipid abnormalities are not documented.

Mixed hyperlipidemia

E78.2
Use E78.2 when both LDL and triglycerides are elevated.

Pure hyperglyceridemia

E78.1
Use E78.1 when only triglycerides are elevated.

Pure hypercholesterolemia

E78.0
Use E78.0 when LDL is specifically elevated.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Hyperlipoproteinemia 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 due to lack of specificity.

Mitigation Strategy

Always document specific lipid levels., Use templates to ensure completeness.

Impact

Reimbursement: May lead to lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of patient records.

Mitigation Strategy

Ensure lipid panel results are documented to specify the type of hyperlipidemia.

Impact

High risk of audits for using unspecified codes without justification.

Mitigation Strategy

Ensure all lipid abnormalities are documented with 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 Hyperlipoproteinemia, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Hyperlipoproteinemia

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

Cardiology patient with mixed hyperlipidemia

Specialty: Cardiology

Required Elements

  • Lipid panel results
  • Family history
  • Current medications

Example Documentation

Patient presents with LDL 180 mg/dL and triglycerides 250 mg/dL. Family history of early CAD. Plan includes statin therapy.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has high cholesterol.
Good Documentation Example
Patient diagnosed with mixed hyperlipidemia (LDL 180 mg/dL, TG 250 mg/dL).
Explanation
The good example provides specific lipid levels and diagnosis.

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