Is E78.01 a billable ICD-10-CM code?

No. E78.01 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does E78.01 sit in the tabular list?

Endocrine, nutritional and metabolic diseases (E00-E89), in the block Metabolic disorders (E70-E88).

What cannot be coded together with E78.01?

E78.01 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above E78.01 (E78) and apply to it just the same.

E78.01

E78.01 — Familial hypercholesterolemia

Non-billable headerICD-10-CM

E78.01 is a non-billable header ICD-10-CM code for familial hypercholesterolemia. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above E78.01

These are not written on E78.01, but they bind it: a note on a category applies to every code beneath it. Billing E78.01 with anything listed here is a denial.

Written on E78 — Disorders of lipoprotein metabolism and other lipidemias

sphingolipidosis (E75.0-E75.3)

Risk adjustment

E78.01 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code history

What changed, and when. Derived by diffing consecutive CMS release files — which matters when you are defending a code assigned under an earlier edition.

deletedFY2024-FY2026
Familial hypercholesterolemia

Code to one of these instead E78.01

3 child codes. Green means billable.

Related codes at this level

Codes that share E78.0. If E78.01 is not quite right, the correct code is usually one of these.

E78.00Pure hypercholesterolemia, unspecified

Questions about E78.01

Is E78.01 a billable ICD-10-CM code?: No. E78.01 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does E78.01 sit in the tabular list?: Endocrine, nutritional and metabolic diseases (E00-E89), in the block Metabolic disorders (E70-E88).
What cannot be coded together with E78.01?: E78.01 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above E78.01 (E78) and apply to it just the same.