ICD-10 Coding for Cholesterol Disorders(E78.0, E78.1, E78.2, Z13.220)
Complete ICD-10-CM coding and documentation guide for Cholesterol Disorders. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cholesterol Disorders
E78.0-E78.9Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes all primary codes related to cholesterol disorders, including hypercholesterolemia and mixed hyperlipidemia.
Encounter for screening for lipoid disorders
This code is used for screening purposes without a prior diagnosis of a cholesterol disorder.
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-C levels are elevated without elevated triglycerides. |
|
| E78.1 | Pure hypertriglyceridemia | Use when triglyceride levels are elevated without elevated LDL-C. |
|
| E78.2 | Mixed hyperlipidemia | Use when both LDL-C and triglycerides are elevated. |
|
| Z13.220 | Encounter for screening for lipoid disorders | Use for screening purposes without a prior diagnosis. |
|
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 cholesterol
Essential facts and insights about Cholesterol Disorders
Primary ICD-10-CM Codes for cholesterol
Decision Criteria
clinical Criteria
- LDL-C levels must be ≥190 mg/dL
Applicable To
- Familial hypercholesterolemia
Excludes
- Hyperlipidemia, unspecified (E78.5)
Clinical Validation Requirements
- LDL-C ≥190 mg/dL
- Normal triglycerides
Code-Specific Risks
- Misclassification with unspecified hyperlipidemia
Coding Notes
- Ensure LDL-C levels are documented and meet the threshold for this code.
E78.1 - Pure hypertriglyceridemia
Use when triglyceride levels are elevated without elevated LDL-C.
Excludes
- Hyperlipidemia, unspecified (E78.5)
Clinical Validation Requirements
- Triglycerides ≥500 mg/dL
Coding Notes
Document triglyceride levels to support this code.
E78.2 - Mixed hyperlipidemia
Use when both LDL-C and triglycerides are elevated.
Excludes
- Hyperlipidemia, unspecified (E78.5)
Clinical Validation Requirements
- LDL-C ≥160 mg/dL
- Triglycerides ≥200 mg/dL
Coding Notes
Ensure both LDL-C and triglyceride levels are documented.
Z13.220 - Encounter for screening for lipoid disorders
Use for screening purposes without a prior diagnosis.
Excludes
- Diagnosed hyperlipidemia (E78 codes)
Clinical Validation Requirements
- Routine screening without symptoms
Coding Notes
Ensure no prior diagnosis of hyperlipidemia is present.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for screening for lipoid disorders
Z13.220Differential 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 Cholesterol Disorders to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E78.0.
Impact
Clinical: Inaccurate diagnosis and treatment, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Use structured templates for documentation., Regular training on coding updates.
Impact
Reimbursement: Potential for reduced reimbursement, Compliance: Increased audit risk, Data Quality: Decreased accuracy of health records
Mitigation Strategy
Ensure documentation supports the most specific code possible.
Impact
Billing both tests on the same day without justification
Mitigation Strategy
Document medical necessity for both tests if billed together.
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 Cholesterol Disorders, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cholesterol Disorders
Use these documentation templates to ensure complete and accurate documentation for Cholesterol Disorders. These templates include all required elements for proper coding and billing.
Routine cholesterol screening
Specialty: Primary CareRequired Elements
- Patient demographics
- Reason for screening
- Lab results
- Follow-up plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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