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Z83.438 ICD-10-CM Code: Family history of other disorder of lipoprotein metabolism and other lipidemia

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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)

Z83.438

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

Family history of other disorder of lipoprotein metabolism and other lipidemia

A family member has other disorders affecting how the body processes fats and lipids, or other lipid-related conditions.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
Z83.4Family history of other endocrine, nutritional and metabolic diseases
Z83.43Family history of other disorder of lipoprotein metabolism and other lipidemias
Z83.438Family history of other disorder of lipoprotein metabolism and other lipidemia

Inclusion Terms

Official
  • Family history of familial combined hyperlipidemia

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Z83.438 in this effective period.

Related Child Codes

Official
Z83.430Family history of elevated lipoprotein(a)

Includes

Official

ICD-10-CM does not list Includes notes for Z83.438 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for Z83.438 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Z83.438 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Z83.438 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for Z83.438 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Use this code for family history of lipid metabolism disorders not specified elsewhere, such as familial hypertriglyceridemia
This is a catch-all code for other specified lipid and lipoprotein disorders in family members

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 Z83.438 an HCC code?

No. Z83.438 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

Z83.438 is the ICD-10-CM diagnosis code for family history of other disorder of lipoprotein metabolism and other lipidemia. A family member has other disorders affecting how the body processes fats and lipids, or other lipid-related conditions. Z83.438 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons with potential health hazards related to family and personal history and certain conditions influencing health status (z77-z99).

Z83.438 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.

Use this code for family history of lipid metabolism disorders not specified elsewhere, such as familial hypertriglyceridemia.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z83.438 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code for family history of lipid metabolism disorders not specified elsewhere, such as familial hypertriglyceridemia
  • This is a catch-all code for other specified lipid and lipoprotein disorders in family members

Child Codes

Code Hierarchy

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