What Are the ICD-10 Codes for Hyperlipidemia?

Table of Contents

• ICD-10 Codes for Hyperlipidemia

• Additional ICD-10 Codes for Greater Specificity

• Coding Guidelines for Hyperlipidemia

Overview of Hyperlipidemia

Hyperlipidemia is a frequently diagnosed metabolic disorder marked by abnormally high levels of lipids in the bloodstream, including cholesterol and triglycerides. These elevated lipid levels increase the risk of cardiovascular complications such as coronary artery disease, heart attack, and stroke.

In the ICD-10-CM classification system, hyperlipidemia falls under the E78 category, which includes disorders of lipoprotein metabolism and other lipidemias. Because hyperlipidemia includes multiple types and subtypes, selecting the correct ICD-10 code requires careful evaluation of clinical documentation and laboratory findings.

For this reason, many healthcare providers rely on professional medical coding and billing services. Coding specialists employed by these services are trained to interpret physician documentation and apply the most accurate ICD-10 codes, ensuring proper reporting and reimbursement.

According to data from the Centers for Disease Control and Prevention, nearly 25 million adults in the United States have total cholesterol levels exceeding 240 mg/dL. In addition, approximately 7 percent of children and adolescents between the ages of 6 and 19 have elevated cholesterol levels. When hyperlipidemia goes undiagnosed or untreated, it can lead to clogged arteries and significantly increase the risk of serious cardiovascular events. Individuals with untreated hyperlipidemia are about twice as likely to develop coronary artery disease compared to those with normal lipid levels. While genetics can play a role, lifestyle factors such as poor diet and lack of physical activity are common contributors.

ICD-10 Codes for Hyperlipidemia

The appropriate ICD-10 code for hyperlipidemia depends on the specific lipid abnormality documented by the provider. Below are the most commonly reported ICD-10 codes related to hyperlipidemia.

E78.0 – Pure Hypercholesterolemia

This code is used when cholesterol levels are elevated without a significant increase in triglycerides.

• E78.00 Pure hypercholesterolemia, unspecified

• E78.01 Familial hypercholesterolemia

Familial hypercholesterolemia is a genetic condition and should be clearly documented to support use of the more specific code.

E78.1 – Pure Hyperglyceridemia

This code applies when triglyceride levels are elevated while cholesterol levels remain relatively normal. It includes conditions such as:

• Elevated fasting triglycerides

• Endogenous hyperglyceridemia

• Fredrickson hyperlipoproteinemia type IV

• Hyperlipidemia group B

• Hyperprebetalipoproteinemia

• Very low density lipoprotein (VLDL) hyperlipoproteinemia

E78.2 – Mixed Hyperlipidemia

This code is assigned when both cholesterol and triglyceride levels are elevated. It is commonly used in patients with combined lipid abnormalities.

E78.3 – Hyperchylomicronemia

This code is reported when extremely high triglyceride levels are present due to enzyme deficiencies involved in lipid metabolism, such as lipoprotein lipase deficiency.

E78.4 – Other Hyperlipidemia

This category is used for specific types of hyperlipidemia not classified elsewhere.

• E78.41 Elevated lipoprotein

• E78.49 Other hyperlipidemia

E78.4 should be used only when documentation supports a distinct lipid disorder that does not fit into other defined categories.

Additional ICD-10 Codes for Greater Specificity

In some cases, additional ICD-10 code for hyperlipidemia  may be required to further describe lipid metabolism disorders or related conditions.

E78.5 – Hyperlipidemia, Unspecified

This code is used when the medical record does not specify the type of hyperlipidemia. It should be avoided whenever more detailed documentation is available.

E78.6 – Lipoprotein Deficiency

This code applies to deficiencies in specific lipoproteins, such as low-density lipoprotein (LDL) or high-density lipoprotein (HDL).

E78.7 – Disorders of Bile Acid and Cholesterol Metabolism

This code is used when abnormalities in bile acid or cholesterol metabolism contribute to lipid disorders.

E78.8 – Other Specified Hyperlipidemia

This code may be assigned for documented hyperlipidemia types not captured by other E78 codes, including secondary hyperlipidemia caused by medications or underlying medical conditions.

E78.9 – Hyperlipidemia, Unspecified

Similar to E78.5, this code is used when the type of hyperlipidemia is not documented. Coders should use this code only as a last resort.

Coding Guidelines for Hyperlipidemia

Accurate ICD-10 coding for hyperlipidemia depends heavily on clear and detailed provider documentation. Coders must select the code that best reflects the patient’s condition at the highest level of specificity supported by the medical record.

Review Medical Documentation Thoroughly

Coding should be based on a comprehensive review of physician notes, diagnostic reports, laboratory results, and relevant clinical findings. Lipid levels, type of hyperlipidemia, and associated conditions must be clearly documented.

Follow ICD-10 Coding Guidelines

Coders should adhere to ICD-10-CM conventions, including code sequencing rules, instructional notes, and guidelines related to combination and secondary codes.

Code to the Highest Level of Specificity

Whenever possible, select specific codes such as pure hypercholesterolemia or mixed hyperlipidemia instead of unspecified codes. Unspecified codes should be used only when documentation lacks sufficient detail.

Identify Underlying Causes and Comorbid Conditions

Hyperlipidemia may be primary or secondary to factors such as medications, diet, obesity, diabetes, or endocrine disorders. It frequently coexists with conditions like hypertension and cardiovascular disease. Additional ICD-10 codes should be reported as appropriate to capture these related diagnoses.

Final Thoughts

Correct ICD-10 coding for hyperlipidemia is essential for accurate reimbursement, data reporting, and continuity of care. Providers should ensure that clinical documentation clearly identifies lipid abnormalities and any associated conditions. When documentation is incomplete or unclear, coding professionals may need to request clarification to ensure accurate code assignment.

Medical billing and coding specialists stay current with ICD-10 updates and guidelines, helping healthcare organizations maintain compliance and accuracy. With detailed documentation and proper coding practices, healthcare providers can support better patient outcomes and more efficient revenue cycle management.