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E78.0 ICD-10-CM Code: Pure hypercholesterolemia

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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Metabolic disorders (E70-E88)

E78.0

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Pure hypercholesterolemia

Pure hypercholesterolemia

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
E78Disorders of lipoprotein metabolism and other lipidemias
E78.0Pure hypercholesterolemia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for E78.0 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E78.0 in this effective period.

Related Child Codes

Official
E78.00Pure hypercholesterolemia, unspecified
E78.01Familial hypercholesterolemia

Includes

Official

ICD-10-CM does not list Includes notes for E78.0 in this effective period.

Excludes 1

Official
  • sphingolipidosis (E75.0-E75.3)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E78.0 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E78.0 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E78.0 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
E78.0
Description
Pure hypercholesterolemia
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

E78.0 is the ICD-10-CM diagnosis code for pure hypercholesterolemia. E78.0 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering metabolic disorders (e70-e88).

Header codes like E78.0 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at E78.0's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E78.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

E78.0 code history

Code setChange
FY2017 (effective Oct 1, 2016)Billability changed (now non-billable header)

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

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