High cholesterol, or hyperlipidemia, is a common health issue. It affects people worldwide, and it’s important to get an accurate diagnosis, not just for treatment, but also for insurance purposes.
That’s where ICD-10 codes come in. ICD-10 codes are used to classify and code diagnoses, symptoms, and procedures. Getting the right ICD-10 code for elevated cholesterol will ensure your doctor can properly treat you.
Here’s a breakdown of the ICD-10 codes for high cholesterol, how they differ from other conditions, and how to ensure accurate coding.
Hyperlipidemia: What you need to know
Hyperlipidemia means you have too much fat, cholesterol, and triglycerides in your blood.
If you don’t get treatment, hyperlipidemia can substantially raise your risk of heart and blood vessel diseases, such as coronary artery disease. It’s estimated that almost 25 million adults in the U.S. have cholesterol levels over 240 mg/dL.
Because hyperlipidemia usually has no symptoms, regular cholesterol screenings are essential.
Hyperlipidemia vs. Dyslipidemia vs. High Cholesterol
These terms are often used interchangeably, but they don’t mean exactly the same thing:
- Hyperlipidemia: This is a broad term for high levels of any kind of fat (lipid) in the blood.
- Dyslipidemia: This term covers any abnormal lipid levels, whether they are high or low.
- High Cholesterol: This refers specifically to high cholesterol levels. It’s a type of hyperlipidemia.
Primary ICD-10 codes for hyperlipidemia
Here are some of the most common ICD-10 codes you’ll use when coding a diagnosis of hyperlipidemia, also known as high cholesterol:
- E78.0 – Pure Hypercholesterolemia: High cholesterol levels without high triglycerides. Subcategories include:
- E78.00 (Unspecified hypercholesterolemia)
- E78.01 (Familial hypercholesterolemia)
- E78.1 – Pure Hyperglyceridemia: High triglyceride levels without high cholesterol.
- E78.2 – Mixed Hyperlipidemia: High levels of both cholesterol and triglycerides.
- E78.3 – Hyperchylomicronemia: High levels of chylomicrons in the blood, often due to genetic disorders or other health conditions.
- E78.5 – Hyperlipidemia, Unspecified: Use this code when the specific type of hyperlipidemia isn’t documented in the patient’s chart.
Other ICD-10 codes to consider
Sometimes, you need to be more specific when coding for elevated cholesterol. Here are a few other codes you might need to know:
- Z13.220: Use this one when you’re coding for hyperlipidemia screening, no matter the results.
- Also, think about adding codes that identify conditions that contribute to a patient’s hyperlipidemia, such as diabetes or hypothyroidism.
Remember, accurate coding means reading the documentation carefully, following the rules, and coding with as much specificity as possible.
Diagnosing Hyperlipidemia
Doctors diagnose hyperlipidemia with a lipid panel. This is a blood test that checks your cholesterol and triglyceride levels. The lipid panel looks at your total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.
Most guidelines recommend routine cholesterol screenings, especially if you have risk factors like a family history of high cholesterol, obesity, or an unhealthy lifestyle.
The ICD-10 code Z13.220 is used when you’re being screened for high cholesterol.
Coding Guidelines and Best Practices
When assigning ICD-10 codes, you should:
- Check your work. Ensure that your clinical documentation is thorough.
- Be specific. Use the most precise ICD-10 code possible to accurately describe the patient’s condition.
- Consider contributing factors. Identify and code any underlying conditions that may be contributing to the hyperlipidemia.
- Get help if you need it. Consider outsourcing your medical coding to a qualified professional.
Key Takeaways
Using the right ICD-10 code for elevated cholesterol is important for accurate medical billing, reporting, and patient care.
Healthcare providers and medical coders need to know the different types of hyperlipidemia and the ICD-10 codes that go with them.
When coding is consistent and accurate, it helps patients and makes healthcare management more efficient.