E78.5
BillableHyperlipidemia, unspecified
HCC Category Mapping
RxHCCHCC 47 — Disorders of Fatty-Acid and Lipid Metabolism
0.000What This Code Means
A general diagnosis of abnormally high fat levels in the blood when the specific type cannot be determined or is not specified.
Coding Tips
- •This is a non-specific code; use only when the type of hyperlipidemia is truly unspecified or unknown
- •Attempt to obtain lipid panel results to assign a more specific E78.4x code if possible
Clinical Significance
Hyperlipidemia, unspecified is one of the most frequently coded diagnoses in outpatient settings but provides minimal clinical specificity. It indicates an abnormal lipid profile without documenting whether cholesterol, triglycerides, or both are elevated, which limits appropriate risk stratification and treatment planning.
Documentation Requirements
- ✓Provider statement or assessment of hyperlipidemia
- ✓Lipid panel results (even if not specifying which component is abnormal)
- ✓Current lipid-lowering treatment
- ✓Cardiovascular risk factor documentation
- ✓Note: Query provider for specificity — the lipid panel almost always identifies the pattern as pure or mixed
Commonly Confused Codes
E78.00 — Pure hypercholesterolemia: preferred when LDL is elevated but triglycerides are normalE78.1 — Pure hyperglyceridemia: preferred when triglycerides are elevated but cholesterol is normalE78.2 — Mixed hyperlipidemia: preferred when both cholesterol and triglycerides are elevatedR78.9 — Finding of unspecified substance in blood: incorrect for a diagnosed lipid disorderE78.9 — Disorder of lipoprotein metabolism, unspecified: even broader than hyperlipidemia unspecified
Code Hierarchy
└E78Disorders of lipoprotein metabolism and other lipidemias└E78.5Hyperlipidemia, unspecified
└E78.5Hyperlipidemia, unspecified