Hyperlipidemia ICD-10 | ICD-10 Coding for Hyperlipidemia

Hyperlipidemia ICD-10 – Overview

The ICD 10 code for Hyperlipidemia, which is a condition characterized by excessive accumulation of lipids or bad cholesterol in the blood, is E78.5. This code may be used as primary or secondary.

What is Hyperlipidemia?

Hyperlipidemia refers to excessive levels of lipids and fats in the blood and tissues. High cholesterol (excessive lipids) can be a significant risk factor for cardiovascular diseases, heart attacks, blocked arteries, and stroke.

Hyperlipidemia can either be primary (genetically defective metabolism) or secondary (due to other medical complications such as obesity, diabetes, hepatitis, liver disease, skin diseases, sleep disorders, chronic kidney disease, etc.)

Hyperlipidemia ICD-10

Hyperlipidemia ICD-10 – What is Hyperlipidemia

Risk factors for hyperlipidemia:

Following are some factors that increase the risk of getting higher levels of lipids in the blood:

  • Abnormal thyroid gland function
  • History of obesity in the family
  • Obesity
  • Excessive consumption of bad fats
  • Excessive alcohol consumption
  • Smoking
  • Diabetes
  • Sedentary lifestyle

Complications of hyperlipidemia:

Hyperlipidemia can form plaques inside the blood vessels, thus blocking blood flow and rupturing the vessels in severe cases.

It can lead to:

  • Coronary artery disease (CAD)
  • Heart attack
  • Narrowing of blood vessels
  • Stroke or brain hemorrhage
  • Cardiovascular and microvascular diseases

What is the ICD-10 coding system?

It is a coding system published by WHO. This system helps keep records of diseases, their diagnosis, procedures related to the treatment, and medical reimbursement in the healthcare system. Coding makes documentation easy and readily available.

What is ICD-10-CM?

ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) is a coding system used by healthcare providers in the United States to record and store the diagnosis, treatments, and services in the hospital setup.

Code structure: The first character is an alpha, the second and third must be numeric, and the fourth up to seven can be either alpha or numeric. The first three characters classify the disease, and the remaining characters provide other details about the injury.

ICD-10 coding for hyperlipidemia:

Below is the complete list of codes used in medical coding when a patient’s document states “Hyperlipidemia” or “high cholesterol,” etc.

The unspecified code for hyperlipidemia is E78.5.

Always report the Other-specified (E78.49) diagnosis code when the specific code for the hyperlipidemia condition is absent.

There is a sole criterion with few Diagnosis codes, meaning that the default diagnosis codes can not bill with that excluded code.

E78.0- Hypercholesterolemia (pure)

E78.00- Unspecified hypercholesterolemia (pure)

E78.01- Familial hypercholesterolemia

E78.1- Pure hyperglyceridemia

  • The cases with an isolated triglyceride level elevation

E78.2- Mixed hyperlipidemia

Use this code when a patient is diagnosed with an elevated level of both cholesterol and triglyceride.

E78.3- Hyperchylomicronemia

E78.4- Other hyperlipidemia

E78.41- Elevated lipoprotein A (lipoprotein (a) is a variant of LDL. It is responsible for atherogenesis and atherosclerosis. Elevated levels lead to plaque formation and increase the risk of heart attack).

E78.5- Unspecified hyperlipidemia

E78.6- Lipoprotein Deficiency

E78.7- Disorders of cholesterol metabolism and bile acid

E78.70- Unspecified bile and cholesterol metabolism disorders

E78.71- Barth syndrome (lipid metabolism disorder due to decreased production of an enzyme, “cardiolipin,” which is responsible for energy metabolism).

E78.72- Smith Lemli Opitz Syndrome (a developmental disorder due to the mutated DHCR7 gene that produces 7-dehydrocholesterol reductase enzyme. This enzyme finalizes the production of cholesterol. Cholesterol is vital for normal embryonic development. A mutation in the DHCR7 gene inhibits the formation of cholesterol).

E78.79- Other disorders of bile acid and cholesterol metabolism.

E78.8- Other disorders of lipoprotein metabolism

E78.81- Lipid dermo-arthritis (lipid metabolism disorder that resembles rheumatoid arthritis and is associated with cutaneous nodules and polyarthritis).

E78.89- Other lipoprotein metabolism disorders

E78.9- Unspecified lipoprotein metabolism disorders

ICD-10 coding guidelines for hyperlipidemia:

ICD-10-CM has provided specific instructions in guidelines to accurately code hyperlipidemia following are some of the key points to consider before coding hyperlipidemia:

  • Select the most specific and accurate code available for the type of hyperlipidemia mentioned in the document.
  • Select the most specific and accurate code for hyperlipidemia. Whenever possible, Also document the underlying cause of hyperlipidemia. This written information is further used to capture a complete clinical picture.
  • If any other conditions or specific manifestations accompany hyperlipidemia, they should be coded separately according to the guidelines for each associated disease.
  • Some combination codes in ICD 10 cover hyperlipidemia and associated manifestations. These codes help simplify the coding process by capturing the relationship between hyperlipidemia and its related conditions in a single code. It is advised to review official guidelines to understand the combination codes, their application, and correct usage.
  • Finally, the official ICD-10-CM coding guidelines are updated now and then. It is essential to stay updated with the instructions on sequencing codes and any other additional documentation requirements.

Types of hyperlipidemia:

According to the “Frederickson” classification, the following are the types of hyperlipidemia:

Type I:

a. Familial Hyperchylomicronemia:

It is an autosomal recessive disorder due to a decrease in the lipoprotein lipase (LPL) enzyme. It leads to the inflammation of the pancreas, eruptive skin with deposition of cholesterol (xanthomas), and an enlarged liver and spleen. It is rare; diet control is essential to manage the symptoms.

b. Apolipoprotein C-II deficiency (familial apoprotein C-II deficiency):

The cause of this type is a defective or altered apoprotein C-II. The symptoms are the same as familial hyperchylomicronemia.

c. Cyclomicronemia due to lipoprotein lipase inhibitor:

The circulating lipoprotein lipase inhibitor in the blood causes an increase in chylomicrons. Symptoms are as same as the above two subtypes of type 1 hyperlipidemia.

Type II:

a. Familial hypercholesterolemia:

It is an autosomal dominant disorder characterized by xanthelasmas (cutaneous plaques on eyelids) and xanthomas on the tendons (particularly the Achilles tendon). It happens because of the deficiency of low-density lipoprotein (LDL) receptors, which increases the blood’s LDL (bad cholesterol).

b. Familial combined hyperlipidemia:

Elevated levels of low-density lipoproteins (LDL) and very low-density lipoproteins (VLDL) in the blood. Along with the decreased LDL receptors, there is a high level of ApoB (Apolipoprotein B acts as a ligand for LDL receptors).

Type III:

Familial dysbetalipoproteinemia:

An increased level of Intermediate-density lipoproteins (IDLs) in the blood. These lipoproteins are the degraded remnants of LDLs, HDLs, and VLDLs. This accumulation happens due to a mutation in the APO E gene, which fails to produce the apolipoprotein E enzyme responsible for fat metabolism. It leads to defective hepatic clearance and the accumulation of cholesterol (xanthomas), especially in palms.

Type IV:

Familial hypertriglyceridemia:

This hyperlipidemia is associated with increased production and decreased low-density lipoproteins (VLDL) elimination.

As a result, the triglyceride levels markedly increase and can lead to pancreatitis.

Type V:

Familial mixed hypertriglyceridemia:

It takes its name from type I and type IV of hyperlipidemia ( hence termed “mixed”). An increased level of chylomicrons as well as VLDLs. Decreased Lipoprotein lipase (LPL) (responsible for the hydrolysis of triglycerides and VLDL) is the main culprit behind this disorder.

Tips for ICD-10 coding for hyperlipidemia:

When the patient’s medical record states any of the above types of hyperlipidemia or hypercholesteremia, choose the diagnosis code carefully from the abovementioned codes in the article. If the diagnosis code doesn’t match the above codes, always use other specified or unspecified Dx.

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Current Version
January 9, 2023
Written By
Asher Ashfaq, OMPT, PT, CPC, CMP

1. JeremyStewart,MD, TracyMcCallin,MD, JulianMartinez, SheebuChacko, MD, ShabanaYusuf,MD,MEd; Hyperlipidemia; Pediatrics In Review; Vol 41; 2020.

2. ICD 10 Version: 2019; World Health Organisation

3. https://icd.who.int/browse10/2019/en#E75.0

4. Rajeev Rajagopal; What Are the ICD-10 Codes for Hyperlipidemia? ; Outsource Strategies International; 2022.

5. Rami A. Ballout, Alan T. Remaley; Pediatric dyslipidemias: lipoprotein metabolism disorders in children; Biochemical and Molecular Basis of Pediatric Disease (Fifth Edition); 2021.


6. Kazuhisa Tsukamoto; Endogenous hypertriglyceridemia; Department of Metabolism, Diabetes and Nephrology, Aizu Medical Center, Fukushima Medical University; 2013.


7. Tayla Holman, Scott Wallask Kristen Lee; ICD-10 (International Classification of Diseases, Tenth Revision); IT Health; 2018.


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