ICD-10 Coding for Low-Density Lipoprotein(E78.01, E78.00)
Complete ICD-10-CM coding and documentation guide for Low-Density Lipoprotein. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Low-Density Lipoprotein
E78.0-E78.6Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes codes for hypercholesterolemia, hyperlipidemia, and related conditions, which are directly relevant to LDL management.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E78.01 | Familial hypercholesterolemia | Use when familial hypercholesterolemia is confirmed by clinical and genetic criteria. |
|
| E78.00 | Pure hypercholesterolemia, unspecified | Use when hypercholesterolemia is present but familial criteria are not met. |
|
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 high LDL
Essential facts and insights about Low-Density Lipoprotein
Primary ICD-10-CM Codes for low-density lipoprotein
Decision Criteria
clinical Criteria
- LDL-C levels and family history
documentation Criteria
- Genetic confirmation of LDLR mutation
Applicable To
- Genetic hypercholesterolemia
Excludes
- Secondary hyperlipidemia (E78.2)
Clinical Validation Requirements
- LDL-C ≥190 mg/dL
- Family history of premature cardiovascular disease
- Genetic testing confirming LDLR mutation
Code-Specific Risks
- Misclassification if genetic testing is not documented
Coding Notes
- Ensure documentation includes genetic testing results if available.
E78.00 - Pure hypercholesterolemia, unspecified
Use when hypercholesterolemia is present but familial criteria are not met.
Applicable To
- High cholesterol
Excludes
- Familial hypercholesterolemia (E78.01)
Clinical Validation Requirements
- LDL-C >160 mg/dL without familial criteria
Coding Notes
Ensure LDL-C levels are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of lipid-lowering agents
Z79.4Differential 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 Low-Density Lipoprotein to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E78.01.
Impact
Clinical: Misdiagnosis risk, Regulatory: Non-compliance with coding guidelines, Financial: Potential claim denials
Mitigation Strategy
Ensure genetic testing results are included in patient records
Impact
Reimbursement: Potential underpayment due to lack of specificity, Compliance: Increased audit risk, Data Quality: Decreased accuracy in health records
Mitigation Strategy
Review patient history and lab results to select the most specific code.
Impact
Using unspecified codes when specific codes are applicable
Mitigation Strategy
Regular training on code specificity and documentation requirements
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 Low-Density Lipoprotein, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Low-Density Lipoprotein
Use these documentation templates to ensure complete and accurate documentation for Low-Density Lipoprotein. These templates include all required elements for proper coding and billing.
Familial hypercholesterolemia diagnosis
Specialty: CardiologyRequired Elements
- LDL-C levels
- Family history
- Genetic testing results
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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