What does ICD-10-CM code E78.00 mean?
E78.00 represents Pure hypercholesterolemia, unspecified. This code falls under Chapter 4 (Endocrine, Nutritional and Metabolic Diseases) and is used for documentation, reporting, and billing of this metabolic condition. Coders frequently reference this code as icd 10 for high cholesterol, icd 10 high cholesterol, icd code for high cholesterol, or high cholesterol.
Code category and hierarchy
- Chapter: 4 – Endocrine, Nutritional and Metabolic Diseases (E00-E89)
- Category: E78
- Code: E78.00 – Pure hypercholesterolemia, unspecified
Guideline notes and coding considerations
Specificity Warning
E78.00 is an unspecified code. Query the provider for greater specificity when documentation suggests a more precise code is available. Using unspecified codes when specific codes exist may trigger audits.
- Excludes1: sphingolipidosis ( E75.0 - E75.3 )
Learn the underlying rules in the ICD-10 Coding Guidelines, Specificity Requirements.
Documentation tips (what coders should confirm)
- Verify the clinical documentation supports the use of E78.00
- Query the provider for greater specificity if clinical details suggest a more precise code
When NOT to use E78.00
Do not assign E78.00 when the clinical scenario involves: sphingolipidosis ( E75.0 - E75.3 ); when documentation provides enough detail for a more specific code. Review excludes notes and assign the most specific code supported by documentation.
Audit risk
E78.00 is an unspecified code. Payers and auditors may flag claims with unspecified codes when the medical record contains sufficient detail for a more precise diagnosis. Query the provider for specificity before submitting.
Validate E78.00 Against ICD 10 CM Coding Guidelines
Check this code against official guidelines for conflicts and compliance issues.
Risk adjustment and HCC mapping
HCC Impact
E78.00 (Pure hypercholesterolemia, unspecified) maps to the following HCC categories: RxHCC V08: HCC 47. Proper documentation using MEAT criteria (Monitor, Evaluate, Assess/Address, Treat) is required for each encounter to support risk-adjusted diagnoses.
Learn more about risk adjustment documentation in our Risk Adjustment & MEAT Documentation Guide.
Related ICD-10 codes
Frequently Asked Questions
The ICD-10-CM code for icd 10 for high cholesterol is E78.00, which represents pure hypercholesterolemia, unspecified. This code is also commonly referenced as icd 10 high cholesterol, icd code for high cholesterol, high cholesterol. Verify this code using the ICD Code Auditor to ensure guideline compliance.
Yes. E78.00 is an active ICD-10-CM diagnosis code used to classify pure hypercholesterolemia, unspecified for clinical documentation, reporting, and medical billing purposes.
Use the ICD Code Auditor to check E78.00 against official ICD-10-CM coding guidelines. The tool validates by fiscal year and patient gender to identify potential conflicts.
E78.00 should be used only when clinical documentation does not provide enough detail for a more specific code. Always query the provider when documentation suggests greater specificity is available, as unspecified codes may trigger audits and impact risk adjustment.
Documentation should clearly describe the clinical condition represented by E78.00 (Pure hypercholesterolemia, unspecified). Include relevant clinical findings, diagnostic test results, provider assessment, and the treatment plan. The diagnosis must be supported by the medical record and not based solely on lab results without clinical interpretation.
Sources
Reviewed by: Certified ICD-10 Coding & Risk Adjustment Specialist
Learn more about our Clinical Coding Review Process