ICD-10 Coding for High Cholesterol(E78.0, E78.2)
Complete ICD-10-CM coding and documentation guide for High Cholesterol. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to High Cholesterol
E78.0-E78.9Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes all primary codes for various types of hyperlipidemia, including pure hypercholesterolemia and mixed hyperlipidemia.
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 cholesterol is ≥190 mg/dL and triglycerides are <200 mg/dL. |
|
| E78.2 | Mixed hyperlipidemia | Use when both LDL cholesterol and triglycerides are elevated. |
|
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 High Cholesterol
Primary ICD-10-CM Codes for high cholesterol
Decision Criteria
clinical Criteria
- LDL cholesterol level ≥190 mg/dL and triglycerides <200 mg/dL
Applicable To
- Elevated LDL cholesterol without elevated triglycerides
Excludes
- Familial hypercholesterolemia (E78.01)
Clinical Validation Requirements
- LDL cholesterol level ≥190 mg/dL
- No elevated triglycerides
Code-Specific Risks
- Incorrect use when triglycerides are elevated.
Coding Notes
- Ensure LDL levels are documented within the past 12 months.
E78.2 - Mixed hyperlipidemia
Use when both LDL cholesterol and triglycerides are elevated.
Applicable To
- Elevated LDL cholesterol with elevated triglycerides
Clinical Validation Requirements
- LDL cholesterol level ≥160 mg/dL
- Triglycerides ≥200 mg/dL
Coding Notes
Document both LDL and triglyceride levels clearly.
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
I25.10Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting High Cholesterol to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E78.0.
Impact
Clinical: Inadequate treatment planning., Regulatory: Increased audit risk., Financial: Potential for denied claims.
Mitigation Strategy
Use templates to ensure lipid levels are documented., Regularly review documentation practices.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Increases risk of audits and denials., Data Quality: Decreases accuracy of patient health records.
Mitigation Strategy
Always document and code based on specific LDL and triglyceride levels.
Impact
Audits may target unspecified codes when specific lipid levels are available.
Mitigation Strategy
Always document and code based on 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 High Cholesterol, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for High Cholesterol
Use these documentation templates to ensure complete and accurate documentation for High Cholesterol. These templates include all required elements for proper coding and billing.
Routine lipid management visit
Specialty: EndocrinologyRequired Elements
- LDL cholesterol level
- Triglyceride level
- Family history of hyperlipidemia
- Current medications
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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