# Why can't hyperlipidemia and prediabetes be coded together?



## TheStephCode (Oct 19, 2015)

Does anyone have a technical explanation or even a guesstimate as to why ICD-10-CM guidelines prohibit hyperlipidemia (E78.5) and prediabetes (R73.09) to be coded together?  

*Abnormal findings on exam of blood, without diagnosis (R70-R79)*
*EXCLUDES1*       lipids (E78.-)

Our physicians are asking why this guideline exists and I would like an answer more savvy than "I don't know, I didn't write the guidelines"!


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## mitchellde (Oct 19, 2015)

I am not certain anyone has a definitive answer for this.  Perhaps it is because the abnormal lab section and the lipids E code are all in the same system and the E code is a diagnosis and the R70-79 states without diagnosis.  I am reaching but really I have no idea, and no physican I have spoke to has any idea.  So we can say the WHO made a mistake, or possibly they didn't and they have reasons why thus edit is there, which does make it not possible for the provider to address both in the same encounter.  Maybe that was the intent?


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## TheStephCode (Oct 19, 2015)

Thank you.  I was really hoping you would be amongst those to read and reply.  I've been all over my books and google this morning trying to figure out some reasoning behind this guideline.

I'm glad to learn we're not the only ones confused by this!


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## TheStephCode (Oct 20, 2015)

For reference:




mitchellde said:


> *This just came in from the WHO* regarding the confusion on the excludes 1 confusion.  Now who is going to tell the payers?  That would be us when we write our appeals!
> 
> *We have received several questions regarding the interpretation of Excludes1 notes in ICD-10-CM when the conditions are unrelated to one another.
> Answer:
> ...


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