Is E78.019 a billable ICD-10-CM code?

Yes. E78.019 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does E78.019 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 E78.019?

E78.019 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 E78.019 (E78) and apply to it just the same.

E78.019

E78.019 — Familial hypercholesterolemia, unspecified

Billable / specific codeICD-10-CM

E78.019 is a billable, specific ICD-10-CM code for familial hypercholesterolemia, unspecified. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Familial hypercholesterolemia NOS

Excludes1 inherited from the categories above E78.019

These are not written on E78.019, but they bind it: a note on a category applies to every code beneath it. Billing E78.019 with anything listed here is a denial.

Written on E78 — Disorders of lipoprotein metabolism and other lipidemias

sphingolipidosis (E75.0-E75.3)

Risk adjustment

E78.019 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.

Medicare coverage

E78.019 is named in 21 Medicare coverage policies — 21 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56289Billing and Coding: Therapeutic Apheresis for Familial Hypercholesterolemia
A56774Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)
A56943Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment
A57037Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment

How E78.019 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to E78.019.

Cholesterolemia›familial
Cholesterolemia›hereditary
Hypercholesterolemia›familial
Hypercholesterolemia›hereditary

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.

addedFY2024-FY2026
Familial hypercholesterolemia, unspecified

Related codes at this level

Codes that share E78.01. If E78.019 is not quite right, the correct code is usually one of these.

Questions about E78.019

Is E78.019 a billable ICD-10-CM code?: Yes. E78.019 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does E78.019 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 E78.019?: E78.019 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 E78.019 (E78) and apply to it just the same.