ICD-10 Coding for Lipid Disorder(E78.0, E78.1, E78.2, E78.5)
Complete ICD-10-CM coding and documentation guide for Lipid Disorder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lipid Disorder
E78.0-E78.5Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes all primary codes for lipid disorders, covering specific types like hypercholesterolemia and hypertriglyceridemia.
Encounter for screening for lipid disorders
Used for preventive screening encounters without symptoms.
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 without elevated triglycerides. |
|
| E78.1 | Pure hypertriglyceridemia | Use when triglycerides are ≥500 mg/dL without elevated cholesterol. |
|
| E78.2 | Mixed hyperlipidemia | Use when both LDL and triglycerides are elevated. |
|
| E78.5 | Unspecified hyperlipidemia | Use only when specific type of hyperlipidemia cannot be determined. |
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 pure hypercholesterolemia
Essential facts and insights about Lipid Disorder
Primary ICD-10-CM Codes for lipid disorder
Decision Criteria
clinical Criteria
- LDL cholesterol level ≥190 mg/dL
Applicable To
- Familial hypercholesterolemia
Excludes
- Hyperlipidemia, unspecified (E78.5)
Clinical Validation Requirements
- LDL ≥190 mg/dL
Code-Specific Risks
- Misclassification if triglycerides are also elevated.
Coding Notes
- Ensure LDL levels are documented clearly.
E78.1 - Pure hypertriglyceridemia
Use when triglycerides are ≥500 mg/dL without elevated cholesterol.
Excludes
- Mixed hyperlipidemia (E78.2)
Clinical Validation Requirements
- Triglycerides ≥500 mg/dL
Coding Notes
Document triglyceride levels clearly.
E78.2 - Mixed hyperlipidemia
Use when both LDL and triglycerides are elevated.
Excludes
- Pure hypercholesterolemia (E78.0)
- Pure hypertriglyceridemia (E78.1)
Clinical Validation Requirements
- LDL ≥160 mg/dL and triglycerides ≥200 mg/dL
Coding Notes
Document both LDL and triglyceride levels.
E78.5 - Unspecified hyperlipidemia
Use only when specific type of hyperlipidemia cannot be determined.
Excludes
- Pure hypercholesterolemia (E78.0)
- Pure hypertriglyceridemia (E78.1)
- Mixed hyperlipidemia (E78.2)
Coding Notes
Avoid use if specific lipid disorder can be identified.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long term (current) use of insulin
Z79.4Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Lipid Disorder 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., Regulatory: Fails to meet documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Use specific terms like 'hypercholesterolemia'., Include lab results in documentation.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of patient data.
Mitigation Strategy
Use specific codes like E78.0 or E78.2 based on lab results.
Impact
Frequent use of E78.5 without justification.
Mitigation Strategy
Ensure specific lipid levels are documented.
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 Lipid Disorder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lipid Disorder
Use these documentation templates to ensure complete and accurate documentation for Lipid Disorder. These templates include all required elements for proper coding and billing.
Lipid Disorder Management
Specialty: Internal MedicineRequired Elements
- Patient history
- Lipid panel results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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