Is E78.1 a billable ICD-10-CM code?

Yes. E78.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does E78.1 sit in the tabular list?

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

E78.1

E78.1 — Pure hyperglyceridemia

Billable / specific codeICD-10-CM

E78.1 is a billable, specific ICD-10-CM code for pure hyperglyceridemia. It is valid for submission on a claim.

Inclusion terms

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

Elevated fasting triglycerides
Endogenous hyperglyceridemia
Fredrickson's hyperlipoproteinemia, type IV
Hyperlipidemia, group B
Hyperprebetalipoproteinemia
Very-low-density-lipoprotein-type [VLDL] hyperlipoproteinemia

Risk adjustment

E78.1 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

E78.1 is named in 18 Medicare coverage policies — 18 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56416Billing and Coding: Assays for Vitamins and Metabolic Function
A56422Billing and Coding: Bariatric Surgical Management of Morbid Obesity
A56675Billing and Coding: Homocysteine Level, Serum
A56943Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment

How E78.1 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 E78.1.

Hyperglyceridemia(endogenous) (essential) (familial) (hereditary) (pure)
Hyperprebetalipoproteinemia(familial)
Hypertriglyceridemia, essential
Prebetalipoproteinemia(acquired) (essential) (familial) (hereditary) (primary) (secondary)
Very-low-density-lipoprotein-type hyperlipoproteinemia(VLDL)
Dyslipidemia›elevated fasting triglycerides
Elevated, elevation›fasting triglycerides
Elevated, elevation›triglycerides
Frederickson's hyperlipoproteinemia, type›IV
High›triglycerides
Hyperlipoproteinemia›very-low-density-lipoprotein-type(VLDL)
Lipoproteinemia›hyper-pre-beta

Related codes at this level

Codes that share E78. If E78.1 is not quite right, the correct code is usually one of these.

Questions about E78.1

Is E78.1 a billable ICD-10-CM code?: Yes. E78.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does E78.1 sit in the tabular list?: Endocrine, nutritional and metabolic diseases (E00-E89), in the block Metabolic disorders (E70-E88).