Cardiology Coding Alert

But be prepared to code 'other' and 'unspecified' hyperlipidemia separately.

Chances are pretty good that high cholesterol will still be a challenge for your patients when ICD-10 goes into effect in 2013. Here's a look at how coding for this, and similar diagnoses, compares between ICD-9 and

ICD-10.

ICD-9-CM Codes:

• 272.0, Pure hypercholesterolemia
• 272.1, Pure hyperglyceridemia
• 272.2, Mixed hyperlipidemia
• 272.4, Other and unspecified hyperlipidemia

ICD-10 Codes:

• E78.0, Pure hypercholesterolemia
• E78.1, Pure hyperglyceridemia
• E78.2, Mixed hyperlipidemia
• E78.4, Other hyperlipidemia
• E78.5, Hyperlipidemia, unspecified

Change: ICD-10 offers a one-to-one code match with ICD-9 for pure hypercholesterolemia (272.0, E78.0), pure hyperglyceridemia (272.1, E78.1), and mixed hyperlipidemia (272.2, E78.2). But where ICD-9 offers one code for "other and unspecified hyperlipidemia" (272.4), ICD-10 offers one code for "other" (E78.4) and a different code for "unspecified" (E78.5).

Documentation: Your clinicians' documentation shouldn't need to change from its current form. All you need to do as a coder to capture this already present information is to format your superbill to capture the difference between "other" and "unspecified" hyperlipidemia. "Other" means the physician documented the type, but ICD-10 doesn't offer a code specific to the documented type. "Unspecified" means the physician did not document the type of hyperlipidemia.

Bonus tip: The notes with the ICD-9 and ICD-10 codes for lipid metabolism disorders are very similar, but there are a few differences. For example, while 272.1 includes "hypertriglyceridemia, essential," E78.1 includes "elevated fasting triglycerides."

Under E78.2, ICD-10 adds "combined hyperlipidemia NOS," "elevated cholesterol with elevated triglycerides NEC," and "Hyperlipidemia, group C." Code E78.2 also has an Excludes1 note, telling you instead to code E78.4 for "familial combined hyperlipidemia" and E78.5 for "cerebrotendinous cholesterosis [van Bogaert-Scherer- Epstein] (E75.5)."

Remember: When ICD-10 goes into effect on Oct. 1, 2013, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.