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E78.00
ICD-10-CM
High Cholesterol

Find information on high cholesterol diagnosis, including ICD-10 codes (E78.0, E78.1, E78.2), clinical documentation improvement tips for hypercholesterolemia, lipid panel interpretation, and cholesterol management guidelines. Learn about LDL cholesterol, HDL cholesterol, triglycerides, and effective strategies for healthcare professionals documenting and coding elevated cholesterol levels. Explore resources for accurate medical coding and compliant clinical documentation of hyperlipidemia and familial hypercholesterolemia.

Also known as

Hyperlipidemia
Hypercholesterolemia
Dyslipidemia

Diagnosis Snapshot

Key Facts
  • Definition : Elevated levels of lipids (fats) in the blood, increasing risk of heart disease.
  • Clinical Signs : Often no symptoms. High cholesterol is detected through a blood test.
  • Common Settings : Primary care clinics, cardiologist offices, labs for blood testing.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC E78.00 Coding
E78.0-E78.9

Pure hypercholesterolemia

Elevated cholesterol levels without other lipid abnormalities.

E78.00-E78.09

Pure hypercholesterolemia

Elevated cholesterol, unspecified type.

E78.1-E78.19

Mixed hyperlipidemia

Elevated cholesterol combined with other lipid abnormalities.

E78.2

Other hyperlipidemia

Elevated lipids not classified elsewhere.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the high cholesterol familial?

  • Yes

    Type of familial hypercholesterolemia?

  • No

    Is it due to a secondary cause?

Code Comparison

Related Codes Comparison

When to use each related code

Description
High cholesterol
Familial hypercholesterolemia
Mixed hyperlipidemia

Documentation Best Practices

Documentation Checklist
  • High cholesterol diagnosis ICD-10 code
  • Elevated LDL cholesterol level documented
  • Triglyceride level recording required
  • HDL cholesterol value specified
  • Family history of hypercholesterolemia

Coding and Audit Risks

Common Risks
  • Unspecified Dyslipidemia

    Coding E78.9 (hyperlipidemia, unspecified) when a more specific code (e.g., for pure hypercholesterolemia) is documented leads to inaccurate risk adjustment and reimbursement.

  • Familial vs. Acquired

    Failing to distinguish between familial (E78.0) and acquired (E78.x) hypercholesterolemia can impact quality reporting and treatment plans.

  • Causative Condition

    Omitting secondary hypercholesterolemia codes (e.g., due to hypothyroidism) can skew population health data and complicate care management.

Mitigation Tips

Best Practices
  • ICD-10 E78.0-E78.9: Accurate cholesterol coding for compliance.
  • Document LDL, HDL, triglycerides: Improve CDI for risk assessment.
  • Lifestyle changes: Diet, exercise for better health outcomes.
  • Statin therapy: Compliant prescribing, monitoring, and patient education.
  • Regular lipid panel: HCC compliance through timely screenings.

Clinical Decision Support

Checklist
  • Check LDL, HDL, triglycerides: ICD-10 E78.5, document levels
  • Assess patient risk factors: family history, diet, smoking
  • Review medications: statins, fibrates, other interactions
  • Calculate ASCVD risk score: document 10-year risk percentage
  • Patient education: lifestyle changes, medication adherence

Reimbursement and Quality Metrics

Impact Summary
  • High Cholesterol Reimbursement: Optimize ICD-10-CM E78.0-E78.9 coding for accurate claims processing. Maximize revenue cycle efficiency with proper documentation.
  • Quality Metrics Impact: Monitor LDL-C control rates (HEDIS measure). Accurate coding impacts performance reporting and value-based payments.
  • Coding Accuracy: Specific diagnosis subtypes (e.g., familial vs. mixed hyperlipidemia) impact reimbursement. Ensure precise coding for optimal payment.
  • Hospital Reporting: Accurate High Cholesterol diagnosis data crucial for public health reporting and resource allocation. Impacts disease management programs.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code primary hypercholesterolemia first
  • Document LDL, HDL, triglycerides
  • ICD-10 E78.0 for pure hypercholesterolemia
  • Use secondary codes for family history
  • Document statin use and response

Documentation Templates

Patient presents today for evaluation and management of hypercholesterolemia, also known as high cholesterol.  The patient reports concerns regarding elevated cholesterol levels discovered during routine bloodwork.  Risk factors for dyslipidemia, including family history of high cholesterol, dietary habits, physical activity levels,  and current medication list, were reviewed.  Physical examination findings were unremarkable, with no xanthomas or xanthelasmas noted.  Laboratory results confirm elevated LDL cholesterol, specifically [insert LDL value mg/dL],  total cholesterol [insert total cholesterol value mg/dL], and triglycerides [insert triglyceride value mg/dL]. HDL cholesterol was [insert HDL value mg/dL].  Based on the patient's lipid panel results, National Cholesterol Education Program (NCEP) ATP III guidelines, and cardiovascular risk assessment, a diagnosis of hyperlipidemia, ICD-10 code E78.5, is confirmed.  The patient's ASCVD risk score was calculated and discussed.  Treatment options including therapeutic lifestyle changes (TLC) such as dietary modifications with emphasis on a low-saturated fat and low-cholesterol diet, increased physical activity, and weight management were thoroughly explained.  Pharmacological interventions, specifically statin therapy, were discussed, considering potential benefits and risks. The patient was educated on the importance of cholesterol management for cardiovascular disease prevention and overall health. Follow-up appointment scheduled in [timeframe] to monitor lipid levels and assess treatment efficacy.  Patient education materials on cholesterol lowering, healthy eating, and exercise were provided.
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