E78.2 – Mixed hyperlipidemia

Billable/ Specific Code:

E78.2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

Clinical Information:

• A disorder of lipoprotein metabolism characterized by high levels of cholesterol and triglycerides in the blood. It is caused by elevation of low density and very low density lipoproteins.
• A type of familial lipid metabolism disorder characterized by a variable pattern of elevated plasma cholesterol and/or triglycerides. Multiple genes on different chromosomes may be involved, such as the major late transcription factor (upstream stimulatory factors) on chromosome 1.
• Type iib hyperlipoproteinemia is caused by mutation in the receptor-binding domain of apolipoprotein b-100 which is a major component of low-density lipoproteins and very-low-density lipoproteins resulting in reduced clearance of these lipoproteins. It is characterized by both hypercholesterolemia and hypertriglyceridemia (combined hyperlipidemia).

Is this code Billable?

Yes

Approximate Synonyms:

• Diabetes type 1 with hyperliidemia
• Diabetes type 2 with hyperlipidemia
• Eruptive xanthoma
• Hyperlipidemia, mixed (high blood fats)
• Mixed hyperlipidemia associated with type 1 diabetes mellitus
• Mixed hyperlipidemia associated with type 2 diabetes mellitus
• Mixed hyperlipidemia due to type 1 diabetes mellitus
• Mixed hyperlipidemia due to type 2 diabetes mellitus
• Tuberous xanthoma
• Xanthoma tuberosum

Applicable To

• 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

ICD-10: A Brief Synopsis

For disease reporting, the US utilizes its own national variant of ICD-10 called the ICD-10 Clinical Modification (ICD-10-CM). A procedural classification called ICD-10 Procedure Coding System (ICD-10-PCS) has also been developed for capturing inpatient procedures. The ICD-10-CM and ICD-10-PCS were developed by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS). There are over 70,000 ICD-10-PCS procedure codes and over 69,000 ICD-10-CM diagnosis codes, compared to about 3,800 procedure codes and roughly 14,000 diagnosis codes found in the previous ICD-9-CM.

The expansion of healthcare delivery systems and changes in global health trends prompted a need for codes with improved clinical accuracy and specificity. The alphanumeric coding in ICD-10 is an improvement from ICD-9 which had a limited number of codes and a restrictive structure. Early concerns in the implementation of ICD-10 included the cost and the availability of resources for training healthcare workers and professional coders.

There was much controversy when the transition from the ICD-9-CM to the ICD-10-CM was first announced in the US. Many providers were concerned about the vast number of codes being added, the complexity of the new coding system, and the costs associated with the transition. The Centers for Medicare and Medicaid Services (CMS) weighed these concerns against the benefits of having more accurate data collection, clearer documentation of diagnoses and procedures, and more accurate claims processing. CMS decided the financial and public health cost associated with continuing to use the ICD-9-CM was too high and mandated the switch to ICD-10-CM.