What is ICD-10 code E78.6?

E78.6 is the ICD-10-CM diagnosis code for Lipoprotein deficiency. A rare condition where the body lacks or has deficient levels of certain lipoproteins needed to transport fats in the blood. It belongs to the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89). E78.6 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E78.6 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. E78.6 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. E78.6 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does E78.6 map to under V28?

E78.6 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for E78.6?

E78.6 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for E78.6?

E78.6 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports E78.6?

This code represents deficiency states rather than excess; verify the diagnosis carefully Document the specific lipoprotein that is deficient (HDL, apolipoprotein, etc.) in the medical record E78.6 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM E78.6: Lipoprotein deficiency

E78.6 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupE78.6

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

E78.6

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Lipoprotein deficiency

A rare condition where the body lacks or has deficient levels of certain lipoproteins needed to transport fats in the blood.

Buddy Insight

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 47

Disorders of Lipoid Metabolism

Code-level coefficient reference

Code Book Path

Official

E78Disorders of lipoprotein metabolism and other lipidemias E78.6Lipoprotein deficiency

Inclusion Terms

Official

Abetalipoproteinemia
Depressed HDL cholesterol
High-density lipoprotein deficiency
Hypoalphalipoproteinemia
Hypobetalipoproteinemia (familial)
Lecithin cholesterol acyltransferase deficiency
Tangier disease

Excludes 2

Official

Ehlers-Danlos syndromes (Q79.6-)Inherited from E70-E88

Related Codes

Official

E78.0Pure hypercholesterolemia E78.1Pure hyperglyceridemia E78.2Mixed hyperlipidemia E78.3Hyperchylomicronemia E78.4Other hyperlipidemia

Includes

Official

No Includes notes are included in this display for E78.6. Check the code and parent instructions in the Code Book.

Excludes 1

Official

transitory endocrine and metabolic disorders specific to newborn (P70-P74)Inherited from E00-E89, E70-E88, E78
androgen insensitivity syndrome (E34.5-)Inherited from E00-E89, E70-E88, E78
congenital adrenal hyperplasia (E25.0)Inherited from E00-E89, E70-E88, E78
hemolytic anemias attributable to enzyme disorders (D55.-)Inherited from E00-E89, E70-E88, E78
Marfan syndrome (Q87.4-)Inherited from E00-E89, E70-E88, E78
5-alpha-reductase deficiency (E29.1)Inherited from E00-E89, E70-E88, E78
sphingolipidosis (E75.0-E75.3)Inherited from E00-E89, E70-E88, E78

Code First

Official

No Code First sequencing instructions are included in this display for E78.6. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for E78.6. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for E78.6. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Specific lipoprotein deficiency type documented (abetalipoproteinemia, hypobetalipoproteinemia, Tangier disease)

Confirmatory lipid testing showing absent or markedly reduced lipoproteins (apoB, HDL)

Genetic testing results if available (MTTP, APOB, ABCA1 mutations)

Clinical manifestations: fat malabsorption, neurological symptoms, retinal changes, acanthocytes on blood smear

MEAT Support

HCC Buddy guidance

Specific lipoprotein deficiency type documented (abetalipoproteinemia, hypobetalipoproteinemia, Tangier disease)

Confirmatory lipid testing showing absent or markedly reduced lipoproteins (apoB, HDL)

Genetic testing results if available (MTTP, APOB, ABCA1 mutations)

Clinical manifestations: fat malabsorption, neurological symptoms, retinal changes, acanthocytes on blood smear

Audit Caution

HCC Buddy guidance

Confusing lipoprotein deficiency (too little) with hyperlipidemia (too much) — they are opposite conditions

Not recognizing Tangier disease or abetalipoproteinemia as forms of lipoprotein deficiency

Coding only the manifestations (neuropathy, retinopathy) without the underlying metabolic disorder

Using hyperlipidemia codes for patients who actually have hypolipidemia/lipoprotein deficiency

Common Mistakes

HCC Buddy guidance

E78.00 — Pure hypercholesterolemia: ELEVATED cholesterol, opposite of lipoprotein deficiency

E78.89 — Other lipoprotein metabolism disorders: for lipoprotein abnormalities not classified as deficiency

E78.9 — Disorder of lipoprotein metabolism, unspecified: too nonspecific when deficiency is confirmed

K90.49 — Malabsorption due to intolerance, not elsewhere classified: fat malabsorption in lipoprotein deficiency is metabolic, not intestinal

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 →

Is E78.6 an HCC code?

E78.6 is not in the CMS-HCC V28 or V24 community payment model. E78.6 has a separate mapping under the Part D RxHCC model (HCC 47 (Disorders of Lipoid Metabolism)); the applicable result needs member context.

Code: E78.6
Description: Lipoprotein deficiency
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

RxHCCHCC 47, Disorders of Lipoid Metabolism

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work E78.6 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for E78.6

For E78.6, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Coder workflow notes

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What This Code Means

E78.6 is the ICD-10-CM diagnosis code for lipoprotein deficiency. A rare condition where the body lacks or has deficient levels of certain lipoproteins needed to transport fats in the blood. E78.6 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering metabolic disorders (e70-e88).

E78.6 has no mapping under the CMS-HCC V28 or V24 community payment models. E78.6 has a separate mapping under the Part D RxHCC model (HCC 47 (Disorders of Lipoid Metabolism)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

This code represents deficiency states rather than excess; verify the diagnosis carefully.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E78.6 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code represents deficiency states rather than excess; verify the diagnosis carefully
•Document the specific lipoprotein that is deficient (HDL, apolipoprotein, etc.) in the medical record

Clinical Significance

Lipoprotein deficiency encompasses conditions like abetalipoproteinemia (Bassen-Kornzweig syndrome), hypobetalipoproteinemia, and Tangier disease, where lipoprotein levels are abnormally LOW rather than high. These rare genetic disorders can cause fat malabsorption, neuropathy, retinopathy, and acanthocytosis, requiring specialized dietary management and fat-soluble vitamin supplementation.

Documentation Requirements

✓Specific lipoprotein deficiency type documented (abetalipoproteinemia, hypobetalipoproteinemia, Tangier disease)
✓Confirmatory lipid testing showing absent or markedly reduced lipoproteins (apoB, HDL)
✓Genetic testing results if available (MTTP, APOB, ABCA1 mutations)
✓Clinical manifestations: fat malabsorption, neurological symptoms, retinal changes, acanthocytes on blood smear
✓Fat-soluble vitamin supplementation plan (vitamins A, D, E, K)
✓Dietary fat restriction or modification plan

Commonly Confused Codes

•E78.00: Pure hypercholesterolemia: ELEVATED cholesterol, opposite of lipoprotein deficiency
•E78.89: Other lipoprotein metabolism disorders: for lipoprotein abnormalities not classified as deficiency
•E78.9: Disorder of lipoprotein metabolism, unspecified: too nonspecific when deficiency is confirmed
•K90.49: Malabsorption due to intolerance, not elsewhere classified: fat malabsorption in lipoprotein deficiency is metabolic, not intestinal