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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 E78.00

Billable / Specific

Pure hypercholesterolemia, unspecified

E78
Block
4
Synonyms
259
LCDs
21
Payer Policies
16
Linked CPTs

About ICD-10-CM E78.00

ICD-10-CM code E78.00 represents Pure hypercholesterolemia, unspecified. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E78). The 2026 edition of ICD-10-CM E78.00 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under E78.00. Per CMS ICD-10-CM Tabular 2026.

  • Fredrickson's hyperlipoproteinemia, type IIa
  • Hyperbetalipoproteinemia
  • Low-density-lipoprotein-type [LDL] hyperlipoproteinemia
  • (Pure) hypercholesterolemia NOS

Medicare LCD Coverage for E78.00

Local Coverage Determinations (LCDs) from CMS MACs that list E78.00 as a covered diagnosis.

259 LCDs

Showing top 10 of 259 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 81517 →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 0344U →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 0003M →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 0468U →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 81599 →
CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis
Article ID: 60305, Effective: , 23 covered, 0 non-covered
CPT 0166U →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81227 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81328 →
CMS LCD: Billing and Coding: Pharmacogenomics Testing
Article ID: 58801, Effective: 2026-01-01 00:00:00, 578 covered, 0 non-covered
CPT 81335 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing E78.00.

21 policies

1 Cigna

Vitamin D Testing - (0526) ---- future effective policy
Policy ID: MM_0526

5 Medicare

Therapeutic Apheresis for Familial Hypercholesterolemia
Policy ID: ART-54543
Billing and Coding: Assays for Vitamins and Metabolic Function
Policy ID: ART-56416
Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Policy ID: ART-56422
Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)
Policy ID: ART-56774
Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment
Policy ID: ART-56943

1 Aetna

Plasmapheresis/Plasma Exchange/Therapeutic Apheresis
Policy ID: CPB-0285

CPT Codes Commonly Billed with E78.00

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

16 linkages
  • 83090 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
  • 83700 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
  • 82172 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
  • 86141 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
  • 83701 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
  • 83719 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
  • 83721 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
  • 83698 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
  • 83695 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD
  • 83704 CMS LCD: Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment CMS LCD

Convert E78.00 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
E78.00 2720 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 E78.00, Billing FAQ

Is ICD-10 code E78.00 billable? +

Yes, E78.00 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to E78.00? +

ICD-10 E78.00 includes: Fredrickson's hyperlipoproteinemia, type IIa; Hyperbetalipoproteinemia; Low-density-lipoprotein-type [LDL] hyperlipoproteinemia, and 1 more clinical synonyms.

What CPT codes are commonly billed with E78.00? +

Procedures frequently paired with E78.00 include: 83090, 83700, 82172, 86141, 83701.

What ICD-9 codes does E78.00 map to? +

Per CMS GEMs, E78.00 maps to ICD-9 codes: 2720. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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