What is ICD-10 code E78.89?

E78.89 is the ICD-10-CM diagnosis code for Other lipoprotein metabolism disorders. It belongs to the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89). E78.89 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. E78.89 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. E78.89 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. E78.89 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.

What is the V28 vs V24 difference for E78.89?

E78.89 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards E78.89 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

What should coders know when reporting E78.89?

Use this code only when the specific lipoprotein disorder is documented but doesn't match more specific codes like E78.0 (pure hypercholesterolemia) or E78.1 (pure hypertriglyceridemia) Always review the medical record for documentation of the specific lipid abnormality and consider querying the provider if the condition could be coded more specifically, as E78.89 is a catch-all code

E78.89: Other lipoprotein metabolism disorders — ICD-10

ICD-10-CM Code View

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Code lookupE78.89Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

E78.89

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

Other lipoprotein metabolism disorders

This code describes lipid metabolism disorders that don't fit into other specific categories, such as unusual patterns of cholesterol or fat processing in the body. These conditions affect how the body breaks down and manages different types of fats in the blood.

Buddy Insight

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Not risk-adjusted for this model/period.

RAF 0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 47

Disorders of Fatty-Acid and L...

RAF 0.0

Code Trumping

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Code Book Path

Official

E78Disorders of lipoprotein metabolism and other lipidemias

E78.8Other disorders of lipoprotein metabolism

E78.89Other lipoprotein metabolism disorders

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for E78.89 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for E78.89 in this effective period.

Related Child Codes

Official

E78.81Lipoid dermatoarthritis

Includes

Official

ICD-10-CM does not list Includes notes for E78.89 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for E78.89 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for E78.89 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for E78.89 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for E78.89 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Specific lipoprotein metabolism disorder documented

Advanced lipid testing results: lipoprotein electrophoresis, apolipoprotein levels, LCAT activity

Genetic testing if familial disorder is suspected

Clinical manifestations and organ involvement

MEAT Support

HCC Buddy guidance

Specific lipoprotein metabolism disorder documented

Advanced lipid testing results: lipoprotein electrophoresis, apolipoprotein levels, LCAT activity

Genetic testing if familial disorder is suspected

Clinical manifestations and organ involvement

Audit Caution

HCC Buddy guidance

Using E78.89 when a more specific lipoprotein disorder code exists elsewhere in E78

Confusing lipoprotein metabolism disorders (how the body processes lipoproteins) with simple hyperlipidemia (elevated circulating lipids)

Coding LCAT deficiency or fish-eye disease under the unspecified E78.9 rather than E78.89

Not recognizing rare lipoprotein disorders that may present with atypical lipid panel results

Common Mistakes

HCC Buddy guidance

E78.6 — Lipoprotein deficiency: for conditions with markedly reduced lipoproteins (abetalipoproteinemia, Tangier disease)

E78.5 — Hyperlipidemia, unspecified: for general lipid elevation without lipoprotein processing focus

E78.9 — Disorder of lipoprotein metabolism, unspecified: more nonspecific version of this code

E78.49 — Other hyperlipidemia: for elevated lipid levels, not lipoprotein processing disorders

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is E78.89 an HCC code?

No. E78.89 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

RxHCCHCC 47, Disorders of Fatty-Acid and Lipid Metabolism

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for E78.89

For E78.89to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

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

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed E78.89 during that encounter, not just copy-forwarded from a problem list.

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What This Code Means

E78.89 is the ICD-10-CM diagnosis code for other lipoprotein metabolism disorders. This code describes lipid metabolism disorders that don't fit into other specific categories, such as unusual patterns of cholesterol or fat processing in the body. These conditions affect how the body breaks down and manages different types of fats in the blood. E78.89 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering metabolic disorders (e70-e88).

E78.89 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

E78.89 maps only to RxHCC 47 (Disorders of Fatty-Acid and Amino-Acid Metabolism) with no RAF weight. No V24 or V28 CMS-HCC mapping. This code has no impact on Medicare Advantage risk adjustment scores. Coders reviewing E78.89 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E78.89 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when the specific lipoprotein disorder is documented but doesn't match more specific codes like E78.0 (pure hypercholesterolemia) or E78.1 (pure hypertriglyceridemia)
•Always review the medical record for documentation of the specific lipid abnormality and consider querying the provider if the condition could be coded more specifically, as E78.89 is a catch-all code

Clinical Significance

Other lipoprotein metabolism disorders captures conditions involving abnormal lipoprotein processing not classified elsewhere, including familial combined hypolipidemia, LCAT deficiency (fish-eye disease), and other rare lipoprotein processing abnormalities. These conditions may have significant cardiovascular or systemic implications requiring specialized management.

Documentation Requirements

✓Specific lipoprotein metabolism disorder documented
✓Advanced lipid testing results: lipoprotein electrophoresis, apolipoprotein levels, LCAT activity
✓Genetic testing if familial disorder is suspected
✓Clinical manifestations and organ involvement
✓Treatment plan specific to the lipoprotein abnormality

Commonly Confused Codes

•E78.6: Lipoprotein deficiency: for conditions with markedly reduced lipoproteins (abetalipoproteinemia, Tangier disease)
•E78.5: Hyperlipidemia, unspecified: for general lipid elevation without lipoprotein processing focus
•E78.9: Disorder of lipoprotein metabolism, unspecified: more nonspecific version of this code
•E78.49: Other hyperlipidemia: for elevated lipid levels, not lipoprotein processing disorders

Child Codes

E78.81Lipoid dermatoarthritis

E78.89Other lipoprotein metabolism disorders

Code Hierarchy

└E78Disorders of lipoprotein metabolism and other lipidemias └E78.8Other disorders of lipoprotein metabolism └E78.89Other lipoprotein metabolism disorders

└E78.89Other lipoprotein metabolism disorders

E78.89 ICD-10-CM Code: Other lipoprotein metabolism disorders

HCC Buddy Code Card

E78.89

Is E78.89 an HCC code?

HCC Category Mapping

MEAT Criteria for E78.89

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Child Codes

Code Hierarchy

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