ICD-10 Coding for Lipid Profile(E78.0, E78.1, E78.2, E78.5)
Complete ICD-10-CM coding and documentation guide for Lipid Profile. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lipid Profile
E78.0-E78.9Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range covers various lipid metabolism disorders, including hypercholesterolemia and 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 persistently elevated above 190 mg/dL. |
|
| E78.1 | Pure hyperglyceridemia | Use when triglyceride levels are significantly elevated, typically ≥500 mg/dL. |
|
| E78.2 | Mixed hyperlipidemia | Use when both LDL cholesterol and triglycerides are elevated. |
|
| E78.5 | Hyperlipidemia, unspecified | Use when specific lipid abnormalities are not identified. |
|
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 lipid profile
Essential facts and insights about Lipid Profile
Primary ICD-10-CM Codes for lipid profile
Decision Criteria
clinical Criteria
- LDL-C ≥190 mg/dL
Applicable To
- Elevated LDL cholesterol
Excludes
- Familial hypercholesterolemia (E78.01)
Clinical Validation Requirements
- LDL-C ≥190 mg/dL
Code-Specific Risks
- Misclassification if LDL-C levels are not documented.
Coding Notes
- Ensure LDL-C levels are documented to support the use of this code.
E78.1 - Pure hyperglyceridemia
Use when triglyceride levels are significantly elevated, typically ≥500 mg/dL.
Applicable To
- Elevated triglycerides
Excludes
- Mixed hyperlipidemia (E78.2)
Clinical Validation Requirements
- Triglycerides ≥500 mg/dL
Coding Notes
Document triglyceride levels to support coding.
E78.2 - Mixed hyperlipidemia
Use when both LDL cholesterol and triglycerides are elevated.
Applicable To
- Elevated LDL and triglycerides
Clinical Validation Requirements
- LDL-C ≥160 mg/dL and triglycerides ≥150 mg/dL
Coding Notes
Document both LDL and triglyceride levels.
E78.5 - Hyperlipidemia, unspecified
Use when specific lipid abnormalities are not identified.
Applicable To
- Unspecified hyperlipidemia
Clinical Validation Requirements
- Total cholesterol >200 mg/dL
Coding Notes
Use when lipid type is not specified.
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
Z79.4Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Lipid Profile to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E78.0.
Impact
Clinical: Impacts treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document specific lipid levels.
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation.
Mitigation Strategy
Ensure lab results support the specific type of hyperlipidemia.
Impact
Using unspecified codes without supporting documentation.
Mitigation Strategy
Ensure lab results are documented and specify lipid type.
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 Profile, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lipid Profile
Use these documentation templates to ensure complete and accurate documentation for Lipid Profile. These templates include all required elements for proper coding and billing.
Lipid management in cardiology
Specialty: CardiologyRequired Elements
- Lipid levels
- Risk scores
- Medication history
- Treatment plans
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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