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

ICD-10 E78.5

Billable / Specific

Hyperlipidemia, unspecified

E78
Block
0
Synonyms
69
LCDs
8
Payer Policies
16
Linked CPTs

About ICD-10-CM E78.5

ICD-10-CM code E78.5 represents Hyperlipidemia, unspecified. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E78). The 2026 edition of ICD-10-CM E78.5 became effective on October 1, 2025.

Medicare LCD Coverage for E78.5

Local Coverage Determinations (LCDs) from CMS MACs that list E78.5 as a covered diagnosis.

69 LCDs

Showing top 10 of 69 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Homocysteine Level, Serum
Article ID: 56675, Effective: 2024-10-01 00:00:00, 550 covered, 0 non-covered
CPT 83090 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43888 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43846 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43771 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43659 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43845 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43886 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43774 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43887 →
CMS LCD: Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Article ID: 56422, Effective: 2026-01-01 00:00:00, 270 covered, 1 non-covered
CPT 43847 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing E78.5.

8 policies

1 Cigna

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

5 Medicare

Billing and Coding: Bariatric Surgical Management of Morbid Obesity
Policy ID: ART-56422
Billing and Coding: Homocysteine Level, Serum
Policy ID: ART-56675
Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment
Policy ID: ART-56943
Billing and Coding: MolDX: Biomarkers in Cardiovascular Risk Assessment
Policy ID: ART-57037
Billing and Coding: Surgical Management of Morbid Obesity
Policy ID: ART-57145

CPT Codes Commonly Billed with E78.5

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

16 linkages
  • 99203 New patient office visit — common complaints plus chronic conditions: HTN, diabetes, hyperlipidemia, asthma, GERD, back pain, migraine, tachycardia, prediabetes Primary Care
  • 99204 New patient office visit — multiple chronic conditions: HTN, T2DM, hyperlipidemia, asthma, anxiety, depression, obesity, IBS, COPD, thyroid, anemia, CAD, sleep apnea, psoriasis, RA Primary Care
  • 99213 Established patient — HTN follow-up, diabetes management, hyperlipidemia, asthma, anxiety, common complaints, back pain, GERD, migraine, acne, joint pain, prediabetes, obesity, anemia, hypothyroid, fatigue Primary Care
  • 99214 Established patient — moderate complexity: uncontrolled HTN, diabetes with complications, multiple chronic conditions, COPD, AFib, CKD, sleep apnea, chronic pain, depression Primary Care
  • 80053 Comprehensive metabolic panel — diabetes, HTN, CKD, hyperlipidemia, electrolyte disorders, anemia, thyroid, prediabetes, abnormal labs, routine exam, screening Laboratory
  • 80061 Lipid panel — hyperlipidemia, hypercholesterolemia, hypertriglyceridemia, CAD, HTN, diabetes, lipid screening, family hx heart disease, obesity Laboratory
  • 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

Convert E78.5 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
E78.5 2724 10000

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

ICD-10 E78.5, Billing FAQ

Is ICD-10 code E78.5 billable? +

Yes, E78.5 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with E78.5? +

Procedures frequently paired with E78.5 include: 99203, 99204, 99213, 99214, 80053.

What ICD-9 codes does E78.5 map to? +

Per CMS GEMs, E78.5 maps to ICD-9 codes: 2724. 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 May 31, 2026.

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