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ICD-10 Code E78.2

What is the code E78.2?

E78.2 is the ICD-10-CM code for mixed hyperlipidemia. This code is used by medical professionals to document and bill for a condition characterized by the presence of elevated levels of lipids in the blood, including cholesterol and triglycerides.

Detailed description of E78.2

Mixed hyperlipidemia (E78.2) refers to a lipid metabolism disorder where both cholesterol and triglycerides are elevated. This condition increases the risk of cardiovascular diseases such as coronary artery disease and stroke. It often requires a combination of lifestyle changes and medication to manage effectively.

Symptoms commonly associated with E78.2

Patients with mixed hyperlipidemia may not exhibit any symptoms initially. However, as the condition progresses, they may experience symptoms such as:

  • Xanthomas (fatty deposits in the skin or tendons)
  • Chest pain (angina)
  • Shortness of breath
  • Fatigue
  • Palpitations
  • E78.0: Pure Hypercholesterolemia
  • E78.1: Pure Hyperglyceridemia
  • E78.49: Other Hyperlipidemia
  • E78.5: Hyperlipidemia, unspecified

Appropriate usage of E78.2 for billing

E78.2 should be used for billing when a patient is diagnosed with mixed hyperlipidemia. Proper documentation should include clinical evidence of elevated cholesterol and triglycerides. Ensure that the diagnosis is supported by lab results and clinical notes to substantiate the billing.

Instructional guidelines for coding E78.2

  • Ensure accurate documentation of lab results showing elevated cholesterol and triglycerides.
  • Use E78.2 when the provider has documented that both cholesterol and triglycerides are elevated or when the provider has specifically documented mixed hyperlipidemia
  • Include relevant patient history and physical examination findings that support the diagnosis.
  • Avoid using this code if the patient only has elevated cholesterol or triglycerides; use more specific codes like E78.0 or E78.1 instead.

E78.2 should be used in accordance with the ICD-10-CM guidelines for coding and reporting. Always ensure that the diagnosis is backed by clinical evidence and documented thoroughly in the patient's medical records.

The following inclusion terms are listed under code E78.2:

  • Broad- or floating-betalipoproteinemia
  • Combined hyperlipidemia NOS
  • Elevated cholesterol with elevated triglycerides NEC
  • Fredrickson's hyperlipoproteinemia, type IIb or III
  • Hyperbetalipoproteinemia with prebetalipoproteinemia
  • Hypercholesteremia with endogenous hyperglyceridemia
  • Hyperlipidemia, group C
  • Tubo-eruptive xanthoma
  • Xanthoma tuberosum

If any of these alternative terms are documented in the medical record, code E78.2 may be assigned.

There is an Excludes 1 note found at E78.2 for the following conditions:

  • Cerebrotendinous cholesterosis [van Bogaert-Scherer- Epstein] (E75.5)
  • Familial combined hyperlipidemia (E78.49)

Due to this instructional note, when the patient has been diagnosed with one of the listed conditions, only the condition noted in the Excludes 1 note should be assigned and E78.2 would be omitted.

There is an Excludes 1 note found at Category E78 Disorders of lipoprotein metabolism and other lipidemias that is applicable to code E78.2 for sphingolipidosis (E75.0-E75.3). This note instructs that when mixed hyperlipidemia is diagnosed with sphingolipidosis, the correct code for sphingolipidosis should be assigned and E78.2 should not be used.

In cases where a patient has a diagnosis of both mixed hyperlipidemia and hypercholesterolemia, only assign code E78.2. Do not assign code E78.00, Pure hypercholesterolemia, unspecified, as the hypercholesterolemia is included in code E78.2 as indicated in the alphabetic index.

Common pitfalls in coding with E78.2

  • Incorrect diagnosis: Using E78.2 when only one type of lipid is elevated.
  • Insufficient documentation: Failing to document lab results that confirm the diagnosis.

Key resources for E78.2 coding


E78.2 is an ICD-10-CM code for documenting and billing mixed hyperlipidemia, a condition that requires careful management due to its association with cardiovascular diseases. Proper documentation, adherence to coding guidelines, and awareness of common pitfalls support accurate coding and billing.

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