E78.019 — Familial hypercholesterolemia, unspecified
Is E78.019 billable?
Yes, but E78.019 is an unspecified code. E78.019 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, E78.019 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting E78.019 — the more specific alternatives are listed below.
E78.019 at a glance
| Code | E78.019 |
|---|---|
| Description | Familial hypercholesterolemia, unspecified |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does E78.019 group to?
E78.019 sits in MDC 10 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 642Inborn and Other Disorders of Metabolismmedical
How is E78.019 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to E78.019. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Cholesterolemia › familial (essential) (pure)
- Cholesterolemia › hereditary (essential) (pure)
- Hypercholesterolemia › familial (essential) (primary) (pure)
- Hypercholesterolemia › hereditary (essential) (primary) (pure)
Inclusion terms
Alternative wording in documentation that is classified to E78.019.
- Familial hypercholesterolemia NOS
Excludes1 — never code together — inherited from Chapter 4
The conditions below can never be reported together with E78.019 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- transitory endocrine and metabolic disorders specific to newborn (P70-P74)
Excludes1 — never code together — inherited from E70-E88
The conditions below can never be reported together with E78.019 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Excludes1 — never code together — inherited from E78
The conditions below can never be reported together with E78.019 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- sphingolipidosis (E75.0-E75.3)
Excludes2 — not included here — inherited from E70-E88
The conditions below are not part of E78.019, but a patient may have both at the same time. When documentation supports it, E78.019 and the excluded code may both be reported.
- Ehlers-Danlos syndromes (Q79.6-)
How long has E78.019 existed?
E78.019 first appears in FY2026.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.