E78.00
BillablePure hypercholesterolemia, unspecified
HCC Category Mapping
RxHCCHCC 47 — Disorders of Fatty-Acid and Lipid Metabolism
0.000What This Code Means
Elevated cholesterol levels in the blood with no specific cause identified, increasing the risk of heart disease and stroke.
Coding Tips
- •Verify whether the hypercholesterolemia is familial or acquired before coding
- •Document LDL and total cholesterol levels when available for clinical context
Clinical Significance
Pure hypercholesterolemia, unspecified represents elevated low-density lipoprotein (LDL) cholesterol without specification of whether it is familial or acquired. While extremely common in the general population, it is a major risk factor for atherosclerotic cardiovascular disease and requires documentation of ongoing management for risk adjustment purposes.
Documentation Requirements
- ✓Provider assessment or diagnosis of pure hypercholesterolemia or elevated LDL cholesterol
- ✓Current lipid panel results with LDL cholesterol level
- ✓Whether familial or non-familial if known (determines more specific code)
- ✓Current treatment: statin therapy, other lipid-lowering agents, dietary modifications
- ✓Treatment response and adherence assessment
- ✓Cardiovascular risk assessment
Commonly Confused Codes
E78.01 — Familial hypercholesterolemia: use when familial/genetic form is confirmed; more specific and preferredE78.2 — Mixed hyperlipidemia: use when both cholesterol AND triglycerides are elevatedE78.5 — Hyperlipidemia, unspecified: broader code when the type of lipid elevation is not documentedE78.41 — Elevated Lipoprotein(a): distinct lipid marker, not the same as LDL cholesterol elevationE78.1 — Pure hyperglyceridemia: elevated triglycerides only, not cholesterol
Code Hierarchy
└E78Disorders of lipoprotein metabolism and other lipidemias└E78.0Pure hypercholesterolemia└E78.00Pure hypercholesterolemia, unspecified
└E78.00Pure hypercholesterolemia, unspecified