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Z13.220
ICD-10-CM
Lipid Panel

Understand your Lipid Panel results with this comprehensive guide. Learn about cholesterol testing, HDL, LDL, triglycerides, lipid profile interpretation, and their implications for cardiovascular health. Explore clinical documentation requirements for lipid disorders, medical coding guidelines for lipid panels, and relevant ICD-10 codes. This resource provides valuable insights for healthcare professionals, including physicians, nurses, and medical coders, seeking information on lipid panel diagnosis, management, and accurate reporting.

Also known as

Cholesterol Test
Lipid Profile

Diagnosis Snapshot

Key Facts
  • Definition : Measures cholesterol and other fats in blood to assess cardiovascular risk.
  • Clinical Signs : Often asymptomatic. High cholesterol can lead to heart disease, stroke.
  • Common Settings : Primary care, cardiology, endocrinology, hospitals, labs

Related ICD-10 Code Ranges

Complete code families applicable to AAPC Z13.220 Coding
E78.0-E78.9

Pure hypercholesterolemia

Elevated cholesterol levels in the blood.

E78.5

Mixed hyperlipidemia

Elevated cholesterol and triglycerides in blood.

E78.2

Mixed hyperglyceridemia

Elevated triglycerides with or without cholesterol elevation.

Code-Specific Guidance

Decision Tree for

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

Is the lipid panel being performed for routine screening?

  • Yes

    Report Z13.220 Encounter for screening for lipoid disorders

  • No

    Is there an abnormal lipid value?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Lipid Panel
Hyperlipidemia
Familial Hypercholesterolemia

Documentation Best Practices

Documentation Checklist
  • Lipid panel diagnosis documentation checklist:
  • ICD-10 codes (e.g., E78.5)
  • Date and time of lipid panel
  • Fasting status (yes/no)
  • Specific lipid values (e.g., LDL, HDL, triglycerides)
  • Clinical indication for testing

Coding and Audit Risks

Common Risks
  • Unbundled Codes

    Using individual lipid component codes (e.g., cholesterol, triglycerides) instead of a comprehensive panel code, leading to overbilling.

  • Unspecified Diagnosis

    Coding with unspecified hyperlipidemia when a more specific diagnosis (e.g., familial hypercholesterolemia) is documented, impacting risk adjustment.

  • Missing LDL Documentation

    Lack of proper LDL documentation to support the lipid panel order, raising medical necessity concerns and potential denials.

Mitigation Tips

Best Practices
  • Document patient fasting status for accurate LDL calculation (ICD-10 Z72.89).
  • Specify lipid fraction tested (e.g., HDL, LDL, triglycerides) for correct CPT coding.
  • Review medication list for lipid-lowering drugs impacting results (RxNorm).
  • Ensure proper units (mg/dL) for lipid values to avoid confusion.
  • Correlate lipid panel with clinical findings for complete CDI and HCC coding.

Clinical Decision Support

Checklist
  • Verify patient fasting status (8-12 hours).
  • Review LDL, HDL, triglycerides, total cholesterol.
  • Check for recent MI, stroke, or other CHD.
  • Assess family history of dyslipidemia.
  • Document ICD-10 code (e.g., E78.5) and LOINC codes.

Reimbursement and Quality Metrics

Impact Summary
  • Lipid Panel Reimbursement: CPT 80061, HCPCS G0445. Accurate coding maximizes payer reimbursement.
  • Coding Accuracy Impact: Correct LOINC, ICD-10 (e.g., E78.5) crucial for clean claims, reduces denials.
  • Quality Metrics Impact: HEDIS measures for cholesterol management. Accurate lipid panel data impacts performance.
  • Hospital Reporting Impact: Affects quality scores, pay-for-performance programs. Data integrity is essential.

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
  • Document LDL, HDL, triglycerides
  • ICD-10-CM E78.5 for hyperlipidemia
  • Check fasting status for accuracy
  • CPT 80061 for lipid panel
  • Consider secondary diagnoses

Documentation Templates

Patient presents for routine lipid panel screening or follow-up evaluation of dyslipidemia, hyperlipidemia, hypercholesterolemia, or high cholesterol.  Relevant family history of coronary artery disease, cerebrovascular accident, or peripheral artery disease was reviewed.  Patient reports adherence to or non-adherence with current lipid-lowering therapy, including statins, fibrates, bile acid sequestrants, niacin, or PCSK9 inhibitors.  Dietary habits, exercise regimen, and smoking status were discussed.  Physical examination findings are unremarkable or may include findings suggestive of hyperlipidemia such as xanthomas or xanthelasmas.  Laboratory results for total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, non-HDL cholesterol, and cholesterolLDL ratio are reviewed and documented.  Assessment includes a diagnosis of hypercholesterolemia, mixed hyperlipidemia, hypertriglyceridemia, isolated low HDL cholesterol, or normal lipid panel.  Plan includes lifestyle modifications such as diet and exercise, continuation or adjustment of current lipid-lowering medications, initiation of new pharmacotherapy, or referral to a cardiologist or lipid specialist for further evaluation and management.  Patient education provided on the importance of cholesterol management, risk factors for cardiovascular disease, and medication adherence.  Follow-up lipid panel scheduled to monitor treatment efficacy and disease progression.  ICD-10 codes such as E78.0, E78.1, E78.2, E78.5, or E78.9 may be applicable.  CPT codes for lipid panel testing, such as 80061, may be billed.