The ICD-10-CM code for hyperlipidemia with no type stated is E78.5, Hyperlipidemia, unspecified. When the provider names the lipid pattern, use the more specific E78 code: E78.00 for high cholesterol, E78.1 for high triglycerides and E78.2 for both.
Hyperlipidemia is one of the most frequently listed diagnoses in primary care and cardiology, which is why small coding habits add up. Two mistakes show up again and again: billing the headers E78.0 and E78.4, which are not valid on a claim, and choosing a code from the lipid numbers instead of from the provider’s diagnosis.
This guide lists every billable code in the hyperlipidemia part of category E78, shows how to choose between them, explains the familial and lipoprotein(a) codes, and covers screening, statin therapy and noncompliance coding.
Key Takeaways
- E78.5 is for hyperlipidemia with no type documented. Use it only when the note gives nothing more specific.
- E78.0 and E78.4 are headers. Report E78.00 or E78.01, and E78.41 or E78.49.
- Code from the provider’s diagnosis, not from lab values. A high LDL on a lab report is not a diagnosis until the provider says so.
- A lipid screening visit is Z13.220, not Z13.6.
- Long-term statin use is Z79.899; medication noncompliance is now Z91.141 or Z91.148, not Z91.14.
Billable Hyperlipidemia Codes in E78
| Code | Official title | Provider documents |
|---|---|---|
| E78.00 | Pure hypercholesterolemia, unspecified | High cholesterol, elevated LDL, hypercholesterolemia |
| E78.01 | Familial hypercholesterolemia | Familial or heterozygous/homozygous FH |
| E78.1 | Pure hyperglyceridemia | Hypertriglyceridemia, high triglycerides only |
| E78.2 | Mixed hyperlipidemia | Both cholesterol and triglycerides raised; combined hyperlipidemia |
| E78.3 | Hyperchylomicronemia | Chylomicronemia syndrome |
| E78.41 | Elevated Lipoprotein(a) | High Lp(a) |
| E78.49 | Other hyperlipidemia | A specified type not listed elsewhere |
| E78.5 | Hyperlipidemia, unspecified | Hyperlipidemia or dyslipidemia with no type |
| E78.6 | Lipoprotein deficiency | A lipoprotein deficiency the provider names |
Do not bill E78.0 or E78.4. Both became headers when they were split into fifth-character codes. Claims with them are rejected as invalid diagnosis codes.
Choosing the Code: Diagnosis First, Numbers Second
Lipid results support the diagnosis, but the coder cannot assign a code from a lab value alone. The provider has to state the condition. Use the lab results to query when the diagnosis is vague and the record clearly shows a pattern.
- Read the assessment. Look for the exact term: hypercholesterolemia, hypertriglyceridemia, mixed, familial or just hyperlipidemia.
- Look the term up in the Index. Dyslipidemia, for example, indexes to E78.5.
- Check for a familial form. Familial hypercholesterolemia is E78.01. Add Z83.42 when a family history of FH is documented for a patient being evaluated.
- Query when the pattern is clear but the term is vague. If the note says hyperlipidemia and the panel shows only raised triglycerides, ask whether hypertriglyceridemia is the intended diagnosis.
Screening, Statins and Adherence Codes
| Situation | Code | Note |
|---|---|---|
| Lipid panel ordered as screening, no known lipid disorder | Z13.220 | Encounter for screening for lipoid disorders. If the result is abnormal and diagnosed, add the E78 code. |
| Patient on long-term statin therapy | Z79.899 | Other long term (current) drug therapy; there is no statin-specific Z79 code. |
| Patient not taking the statin as prescribed | Z91.141 or Z91.148 | Z91.141 when due to financial hardship, Z91.148 for other reasons. |
| Statin intolerance with a documented reaction | The reaction, then T46.6X5- | Adverse effect of antihyperlipidemic drugs. |
When a statin raises liver enzymes, see our elevated liver enzymes ICD-10 guide for how to sequence the finding and the adverse-effect code.
Related Conditions Coded Alongside E78
ICD-10-CM does not presume a link between hyperlipidemia and other conditions, so each one the provider manages is coded on its own.
- Coronary artery disease: I25.10, or an I25.11- combination code when angina is documented.
- Type 2 diabetes: the E11 code that matches the documented complications.
- Hypertension: I10, or the combination code if heart or kidney disease is linked.
- Obesity: E66.811 to E66.813 by class, with the Z68 BMI code when documented. The same documentation supports referrals for medical nutrition therapy and, when payer criteria are met, bariatric surgery.
- Fatty liver: K76.0; see our fatty liver ICD-10 guide.
Worked Examples
Example 1. Assessment: mixed hyperlipidemia, continue atorvastatin. Codes: E78.2, Z79.899.
Example 2. Assessment: elevated Lp(a), family history of early heart disease. Codes: E78.41, Z82.49 for family history of ischemic heart disease.
Example 3. Assessment: hyperlipidemia, stopped statin because of cost. Codes: E78.5, Z91.141. Query the provider if the record supports a more specific type.
Running into invalid-code rejections after annual updates? Steady Medical Billing’s certified coders keep chronic condition codes current each October so problem-list codes do not carry forward as headers.
Frequently Asked Questions
What is the ICD-10 code for hyperlipidemia?
E78.5, Hyperlipidemia, unspecified, is used when no type is documented. Use E78.00 for pure hypercholesterolemia, E78.1 for hypertriglyceridemia and E78.2 for mixed hyperlipidemia when the provider names the type.
Is E78.0 a billable code?
No. E78.0 is a header. Report E78.00 for pure hypercholesterolemia, unspecified, or E78.01 for familial hypercholesterolemia.
What is the ICD-10 code for dyslipidemia?
Dyslipidemia indexes to E78.5, Hyperlipidemia, unspecified, unless the provider documents a more specific type.
How do I code long-term statin use?
Use Z79.899, Other long term (current) drug therapy, together with the E78 code for the lipid disorder being treated.
What code is used for lipid screening?
Z13.220, Encounter for screening for lipoid disorders. Z13.6 is screening for cardiovascular disorders and is not the lipid screening code.
