What Is the ICD-10 Code for Hyperlipidemia? Common Codes Explained

Hyperlipidemia is among the most common chronic conditions that physicians treat within primary care medicine, cardiovascular medicine, and endocrinology practices across the country. The correct utilization of ICD-10 codes for hyperlipidemia in insurance claim forms is an essential requirement due to its impact on medical necessity determination, risk adjustment for value-based payment methods, and coverage criteria compliance for certain prevention and treatment measures.

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Choosing the appropriate ICD-10 code for hyperlipidemia will depend on the documentation entered by the physician – which, incidentally, means knowing about all of the codes available in this section.

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This guide includes the major ICD-10-CM codes within category E78 (Disorders of lipoprotein metabolism and other lipidemias), including hyperlipidemia and related lipid metabolism disorders.

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Understanding ICD-10-CM Chapter Placement for Hyperlipidemia

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Hyperlipidemia and related disorders belong to Chapter 4: Endocrine, Nutritional and Metabolic Diseases (ICD-10-CM; E00–E89). To be more precise, among them, there is a subchapter of codes, namely, E78 – Disorders of lipoprotein metabolism and other lipidemias. Within E78, there can be found Elevated cholesterol, Elevated triglycerides, Mixed hyperlipidemia, Hyperchylomicronemia, and Lipid deficiency disorders.

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These codes and related conditions include E78.0 (pure hypercholesterolemia), E78.1 (pure hyperglyceridemia), E78.2 (mixed hyperlipidemia), E78.3 (hyperchylomicronemia), E78.4 category (other hyperlipidaemia) containing E78.41 and E78.49, E78.5 (hyperlipidaemia unspecified), and E78.6-E78.9 (deficiencies & other disorders).

Complete ICD-10-CM Code Reference: E78 Disorders of Lipoprotein Metabolism (FY2026)

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The following table covers every valid ICD-10 code for hyperlipidemia and related lipid disorders in the current FY2026 ICD-10-CM tabular list, effective October 1, 2025.

The Most Commonly Used ICD-10 Codes for Hyperlipidemia in Practice

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Although there are several codes within the complete E78 classification group, four of them represent by far the biggest percentage of claims submitted under the hyperlipidemia diagnosis in both outpatient and inpatient settings. Knowing all four well enough is the key to proper coding.

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E78.5 - Hyperlipidemia, Unspecified

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E78.5 would be the automatic code choice to use for reporting hyperlipidemia whenever the provider documents “hyperlipidemia” without stating the type of lipid abnormalities. The utilization of E78.5 code could therefore be considered to be justified, frequent and excessive.

The proper usage of E78.5 could include instances when: – no type of lipid abnormalities is mentioned in the documentation, or when “hyperlipidemia” is noted without any additional information.

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E78.00 - Hypercholesterolemia, Unspecified

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The ICD-9-CM code E78.00 indicates isolated hypercholesterolemia with an elevation in total cholesterol levels and/or LDL cholesterol but no significant triglyceride elevation. This condition is related to the Fredrickson-Levy-Rees type IIa hyperlipidemia that is frequently seen among those who are on statins. E78.00 is generally appropriate in cases where there is a diagnosis of isolated hypercholesterolemia or elevated LDL cholesterol.

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E78.2 - Mixed Hyperlipidemia

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ICD-10 codes for hyperlipidemia associated with high levels of triglycerides as well as high levels of cholesterol at the same time include code E78.2. The use of this code is recommended in situations involving patients who have hyperlipidemia that can be described using mixed hyperlipidemia, Fredrickson Types IIb and III, and wide beta hyperlipidemia. It is used in situations involving metabolic syndrome.

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E78.1 - Pure Hyperglyceridemia

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The pure type of hyperlipidemia in which the presence of high triglycerides does not come with any problem with the cholesterol is known as E78.1. The types of pure hyperlipidemia include Type IV of Fredrickson (hypertriglyceridemia), VLDL hypertriglyceridemia, and hyperprebetalipoproteinemia. 

What Physicians Need to Document for Accurate Hyperlipidemia Coding

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The ICD-10 code for hyperlipidemia that ends up on a claim is only as accurate as the documentation the coder has to work with. Many of the specificity failures in hyperlipidemia coding are not coder errors; they are documentation gaps. Here is what the clinical note needs to contain:

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• Type of lipid abnormality: Is it high cholesterol, elevated triglyceride levels, or both? These are the basic differences between E78.00, E78.1, and E78.2.

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• Familial vs. Acquired: If the doctor has found or even suspected that the condition is due to familial hypercholesterolemia, then the medical notes should have the exact statement "familial hypercholesterolemia" or "FH".

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• Specific Laboratory Values cited: Lab values of total cholesterol, LDL, HDL, and triglyceride levels in the notes assist in identifying the correct code.

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• Other conditions: In case the diagnosis of hyperlipidemia is linked to diabetes mellitus, hypothyroidism, and obesity, the two diagnoses should be recorded as well.

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• Plan of Treatment: The use of statins, fibrates, ezetimibe, PCSK9 inhibitor (evolocumab/ alirocumab), and diet modification supports the clinical justification of the visit and tests.

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• Controlled/Uncontrolled: Even though there are no specific codes for controlled and uncontrolled hyperlipidemia in the ICD-10-CM coding system, unlike diabetes, the recording of control status helps in risk stratification of patients.

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Common ICD-10 Coding Errors for Hyperlipidemia - and How to Avoid Them

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• Error 1: Use of E78.5 in all cases of hyperlipidemia. If "high cholesterol" has been documented by the physician, then E78.00 must be assigned for hyperlipidemia and not E78.5.

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• Error 2: Code E78.01 without familial documentation. Familial hypercholesterolemia (E78.01) necessitates that there must be documentation of this type of hyperlipidemia by the physician. High LDL does not mean E78.01.

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• Error 3: Using Code E78.2 without reviewing the situation. If the patient is diagnosed with hyperlipidemia (cholesterol and triglycerides) at one time, code E78.2 is used. But it is important that you need to review the documentation carefully.

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• Error 4: Not coding the underlying cause if secondary. In the case when hyperlipidemia is caused by other underlying conditions like diabetes or hypothyroidism, coders should use ICD-10-CM codes and report the disease causing the visit first.

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• Error 5: Missing the appropriate code Z79.899. In the case of patients who are under the influence of drugs such as statins and PCSK9 for a long period of time to treat hyperlipidemia, Z79.899 should be used.

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• Error 4: Not coding the underlying cause if secondary. In the case when hyperlipidemia is caused by other underlying conditions like diabetes or hypothyroidism, coders should use ICD-10-CM codes and report the disease causing the visit first.

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• Error 5: Missing the appropriate code Z79.899. In the case of patients who are under the influence of drugs such as statins and PCSK9 for a long period of time to treat hyperlipidemia, Z79.899 should be used.

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Coding Secondary Hyperlipidemia

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Secondary hyperlipidemia refers to the situation whereby the lipid problem exists due to another medical condition, drug usage, or lifestyle factors. ICD-10-CM doesn't have one particular code for "secondary hyperlipidemia," but rather codes the proper E78 code depending on what type of lipids are involved, and places the code after any underlying condition where the former causes the latter.

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Accurate sequencing of secondary hyperlipidemia is essential when assigning DRGs to inpatients and for risk adjustment in value-based care. Experienced coders who accurately sequence hyperlipidemia will produce better clinical documentation than those who use E78.5 as the only code.

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How RapidClaims Supports Accurate Hyperlipidemia Coding

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Incorrectly coded claims lead to inaccurate risk scoring, undercounting of HCCs, and unnecessary denials of medical necessity for lab and treatment services.

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The RapidClaims solution is purpose-built to fill that void on a wide scale. Using artificial intelligence (AI) enabled coding logic, the system helps billers pick the right ICD-10 code for hyperlipidemia in their clinical documents, not according to what they feel like submitting by habit or because it’s easier to do.

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In the case of hyperlipidemia, RapidClaims will help coders:

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• Check overuse of E78.5 by verifying whether the physician documents any specific lipid (cholesterol, triglycerides, or both) and yet submits the E78.5 code
• Verify E78.01 coding by ensuring that there is evidence of familial hypercholesterolemia in the record
• Detect secondary coding opportunities by bringing up the Z79.899 (long-term drug therapy) code when statin or PCSK9 inhibitor treatment is documented in the record
• Implement sequencing logic by making sure that underlying conditions such as diabetes or hypothyroidism, which contributed to the visit, precede E78 codes
• Monitor denial trends by ICD-10 code for E78.5, E78.00, or E78.2 to see whether claims with particular codes receive more denials than other claims

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Final Thoughts: Getting the ICD-10 Code for Hyperlipidemia Right in 2026

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Hyperlipidemia can be considered an uncomplicated example of coding. There is nothing complicated about coding the condition – it happens frequently, and the codes do not need much clarification. E78.5 remains an acceptable unspecified code when the provider does not document the specific lipid abnormality.

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In other words, E78.00 for hypercholesterolemia, E78.01 for familial hypercholesterolemia, E78.1 for hypertriglyceridemia, E78.2 for other combinations, and E78.5 if there is a question – is not something difficult to manage. On the contrary, this approach corresponds to what ICD-10-CM coding requires. It also satisfies the requirements for reimbursement, quality measurement, and risk adjustment.

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Coding specialists who have profound knowledge about the E78 subcategory, request more details for coding, and track their use of the ICD-10 code for hyperlipidemia are those who submit the best claims.

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FAQs

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Q1. What ICD-10 code can be applied for hyperlipidemia unspecified?

ICD-10-CM code for hyperlipidemia unspecified is E78.5. The diagnosis is applicable if hyperlipidemia is documented by the practitioner, but there is no mention of which lipids are elevated.

Q2. What ICD-10 code can be applied for mixed hyperlipidemia?

ICD-10-CM code for mixed hyperlipidemia is E78.2. This condition applies when there is high cholesterol and high triglyceride levels.

Q3. Can you say whether E78.5 is the ICD-10 code for pure hypercholesterolemia?

ICD-10-CM code for pure hypercholesterolemia is E78.00. The code is common for high LDL cholesterol and high total cholesterol.

Q4. In what cases can you use E78.5 code for hyperlipidemia?

It is possible to apply this code if there is a documented case of hyperlipidemia, but there is no specification regarding cholesterol or triglycerides.

Q5. Are E78.2 and E78.5 the same codes?

E78.2 is the code of choice if cholesterol and triglycerides are elevated at the same time, while E78.5 refers to unspecified hyperlipidemia.

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