E78.49 — Other hyperlipidemia
E78.49 is a billable, specific ICD-10-CM code for other hyperlipidemia. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Familial combined hyperlipidemia
Excludes1 inherited from the categories above E78.49
These are not written on E78.49, but they bind it: a note on a category applies to every code beneath it. Billing E78.49 with anything listed here is a denial.
Other codes that can never be billed with E78.49
These codes carry an Excludes1 note pointing at E78.49. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading E78.49 alone.
- E78.2Mixed hyperlipidemia
Risk adjustment
E78.49 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
E78.49 is named in 12 Medicare coverage policies — 12 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 E78.49 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 E78.49.
- Hyperlipemia, hyperlipidemia›specified NEC
- Hyperlipemia, hyperlipidemia›combined›familial
Code history
E78.49 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share E78.4. If E78.49 is not quite right, the correct code is usually one of these.
Questions about E78.49
- Is E78.49 a billable ICD-10-CM code?
- Yes. E78.49 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does E78.49 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 E78.49?
- E78.49 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 E78.49 (E78) and apply to it just the same.