2025 ICD-10-CM code E78.5
(Active) Effective Date: N/A Endocrine, nutritional and metabolic diseases - Disorders of lipoprotein metabolism and other lipidemias 4 Feed
Hyperlipidemia, unspecified. This code is used when the specific type of hyperlipidemia is not documented or known.
Medical necessity for services related to hyperlipidemia should be supported by the patient's diagnosis, severity of symptoms, and treatment plan. Documentation should demonstrate the need for interventions such as medication management, lifestyle modifications, or further diagnostic testing.
Providers diagnose the condition based on the patient’s family history, signs and symptoms, and physical examination. Laboratory tests include a lipid panel to measure cholesterol levels and genetic testing. Imaging studies include echocardiogram. Treatment depends on disease severity and may include prescription drugs such as statins to reduce cholesterol levels, diet modification, and advice to exercise.
In simple words: High levels of fats (lipids) in the blood, without specifying the exact type of fat problem.
Unspecified hyperlipidemia refers to an inherited metabolic disorder caused by the body’s inability to metabolize low–density lipoprotein (LDL), which leads to elevated levels of triglycerides, cholesterol, and other lipids in the blood. Risk factors include diabetes, hypothyroidism, obesity, and alcohol abuse.
Example 1: A patient presents with elevated cholesterol and triglyceride levels, but the physician does not specify the type of hyperlipidemia., A patient with a family history of hyperlipidemia is found to have elevated lipid levels during a routine check-up. The specific type is not yet determined., A patient is admitted to the hospital with chest pain, and initial lab tests reveal high cholesterol and triglycerides. Further investigation is needed to classify the hyperlipidemia.
Documentation should include lipid panel results (total cholesterol, LDL, HDL, triglycerides), family history, relevant signs and symptoms, and any other diagnostic tests performed. The provider's assessment and plan of care should also be documented.
- Payment Status: Active
- Specialties:Endocrinology, cardiology, internal medicine, family medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, etc.