ICD-10 Coding for Lipid Disorders(E78.0, E78.1, E78.2)
Complete ICD-10-CM coding and documentation guide for Lipid Disorders. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lipid Disorders
E78.0-E78.5Primary Range
Disorders of lipoprotein metabolism and other lipidemias
This range includes all primary codes for lipid metabolism disorders, covering various types of hyperlipidemia and related conditions.
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 elevated without triglyceride elevation. |
|
| E78.1 | Pure hyperglyceridemia | Use when triglycerides are elevated without LDL elevation. |
|
| E78.2 | Mixed hyperlipidemia | Use when both LDL 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 lipid disorders
Essential facts and insights about Lipid Disorders
Primary ICD-10-CM Codes for lipid
Decision Criteria
clinical Criteria
- LDL cholesterol level ≥190 mg/dL
Applicable To
- High cholesterol
Excludes
- Familial hypercholesterolemia (E78.01)
Clinical Validation Requirements
- LDL ≥190 mg/dL
Code-Specific Risks
- Misclassification if triglycerides are also elevated.
Coding Notes
- Ensure LDL levels are documented and no secondary causes are present.
E78.1 - Pure hyperglyceridemia
Use when triglycerides are elevated without LDL elevation.
Applicable To
- High triglycerides
Excludes
- Mixed hyperlipidemia (E78.2)
Clinical Validation Requirements
- Triglycerides ≥200 mg/dL
Coding Notes
Ensure triglyceride levels are documented and no secondary causes are present.
E78.2 - Mixed hyperlipidemia
Use when both LDL and triglycerides are elevated.
Applicable To
- Combined hyperlipidemia
Excludes
- Pure hypercholesterolemia (E78.0)
- Pure hyperglyceridemia (E78.1)
Clinical Validation Requirements
- LDL ≥160 mg/dL and triglycerides ≥150 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.
Long term (current) use of insulin
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 Lipid 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: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims.
Mitigation Strategy
Always ask about family history of cardiovascular disease., Document any relevant family history in the patient's record.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases the accuracy of health records.
Mitigation Strategy
Ensure lipid panel results are documented to select the most specific code.
Impact
Frequent use of E78.5 without justification.
Mitigation Strategy
Ensure lipid panel results are documented and specific codes are used.
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 Disorders, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lipid Disorders
Use these documentation templates to ensure complete and accurate documentation for Lipid Disorders. These templates include all required elements for proper coding and billing.
Cardiology Progress Note
Specialty: CardiologyRequired Elements
- Patient history
- Family history of cardiovascular disease
- Current lipid levels
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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