E78.41 ICD-10-CM Code: Elevated Lipoprotein(a)
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 1 inclusion term · 6 Excludes1 · 1 Excludes2
- Risk adjustment
- RxHCC V08 category 47
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 642 — INBORN AND OTHER DISORDERS OF METABOLISM (MDC 10)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for E78.41 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on E78.41 itself; “inherited from” names the category or block whose note applies here.
Inclusion Terms
Alternative terms the tabular list files under this code.
- Elevated Lp(a)
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- sphingolipidosis (E75.0-E75.3) inherited from E78Compare E78.41 vs E75.0 →
- androgen insensitivity syndrome (E34.5-) inherited from E70-E88Compare E78.41 vs E34.5 →
- congenital adrenal hyperplasia (E25.0) inherited from E70-E88Compare E78.41 vs E25.0 →
- hemolytic anemias attributable to enzyme disorders (D55.-) inherited from E70-E88Compare E78.41 vs D55 →
- Marfan syndrome (Q87.4-) inherited from E70-E88Compare E78.41 vs Q87.4 →
- 5-alpha-reductase deficiency (E29.1) inherited from E70-E88Compare E78.41 vs E29.1 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- Ehlers-Danlos syndromes (Q79.6-) Compare E78.41 vs Q79.6 →
Source: inherited from E70-E88
Coder workflow for E78.41
MedCoder structured workflow — derived from this code’s own official record
Before you code E78.41
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with E78.41. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the documentation support a condition named in E78.41’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.
Consider E78.41. Then confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Official instructions as workflow
Excludes1 — check before selecting E78.41(6 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with E78.41: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareE34.5, E25.0, D55, Q87.4, E29.1
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of E78.41(1 note)
Coding workflow: The conditions named in this note are not included in E78.41. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareQ79.6
See the official tabular notes · Guidelines I.A.12.b
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Both the condition E78.41 describes and a condition named in its Excludes1 note are documented for the same encounter.
Coding question: Can both codes be reported?
Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.
Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Indexed Clinical Terms (2)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
Verify Before Coding
- No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
Other codes that name E78.41 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 1 Excludes1 note: P59 — Neonatal jaundice from other and unspecified causes (via E78.-).
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Referenced by 15 Excludes2 notes across 4 chapters: E88.0 — Disorders of plasma-protein metabolism, not elsewhere classified (via E78.-), G11 — Hereditary ataxia (via E78.-), G71 — Primary disorders of muscles (via E78.-), N25.0 — Renal osteodystrophy (via E78.-), N25.81 — Secondary hyperparathyroidism of renal origin (via E78.-), R70 — Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity (via E78.-), R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79) (via E78.-), R71 — Abnormality of red blood cells (via E78.-), R73 — Elevated blood glucose level (via E78.-), R74 — Abnormal serum enzyme levels (via E78.-), R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV] (via E78.-), R76 — Other abnormal immunological findings in serum (via E78.-), R77 — Other abnormalities of plasma proteins (via E78.-), R78 — Findings of drugs and other substances, not normally found in blood (via E78.-), R79 — Other abnormal findings of blood chemistry (via E78.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Referenced by 2 Code First instructions across 2 chapters: G63 — Polyneuropathy in diseases classified elsewhere (via E78.-), H42 — Glaucoma in diseases classified elsewhere (via E78.-).
Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.
Named in the grouper logic of 1 MS-DRG: DRG 642 (MDC 10).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):END010 — Disorders of lipid metabolism (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Disorders of lipid metabolism).
E78.0 — Pure hypercholesterolemia, E78.00 — Pure hypercholesterolemia, unspecified, E78.01 — Familial hypercholesterolemia, E78.010 — Homozygous familial hypercholesterolemia [HoFH], E78.011 — Heterozygous familial hypercholesterolemia [HeFH], E78.019 — Familial hypercholesterolemia, unspecified, E78.1 — Pure hyperglyceridemia, E78.2 — Mixed hyperlipidemia, E78.3 — Hyperchylomicronemia, E78.4 — Other hyperlipidemia, E78.49 — Other hyperlipidemia, E78.5 — Hyperlipidemia, unspecified
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Elevated, elevation”; these codes share that main term but sit in a different category of the Tabular List.
D72.820 — Lymphocytosis (symptomatic) (lymphocytes), D72.828 — Other elevated white blood cell count (white blood cell count, specified NEC), D72.829 — Elevated white blood cell count, unspecified (leukocytes), H51.0 — Palsy (spasm) of conjugate gaze (conjugate, eye), I87.8 — Other specified disorders of veins (venous pressure), Q74.0 — Other congenital malformations of upper limb(s), including shoulder girdle (scapula, congenital), Q79.1 — Other congenital malformations of diaphragm (diaphragm, congenital), R03.0 — Elevated blood-pressure reading, without diagnosis of hypertension (blood pressure, reading, no diagnosis of hypertension), R17 — Unspecified jaundice (liver function, test, bilirubin), R50.9 — Fever, unspecified (body temperature), R70.0 — Elevated erythrocyte sedimentation rate (sedimentation rate), R73.01 — Impaired fasting glucose (fasting glucose), R73.02 — Impaired glucose tolerance (oral) (glucose tolerance), R73.9 — Hyperglycemia, unspecified (blood sugar), R74.01 — Elevation of levels of liver transaminase levels (AST), R74.02 — Elevation of levels of lactic acid dehydrogenase [LDH] (lactic acid dehydrogenaselevel), R74.8 — Abnormal levels of other serum enzymes (liver function, test, hepatic enzyme), R76.0 — Raised antibody titer (antibody titer), R76.89 — Other specified abnormal immunological findings in serum (immunoglobulin level), R79.82 — Elevated C-reactive protein (CRP) (C-reactive protein), +8 more
Lab tests where this diagnosis supports Medicare coverage (NCD)
Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.
Blood Glucose Test, Gamma-glutamyl Transferase (GGT) Test, Lipid Panel, Thyroid Stimulating Hormone (TSH)
Contextual Map
Every relationship of E78.41 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Run E78.41 with these 11 related codes in Claim Check
Hierarchy
- E00-E89 — Chapter 4: Endocrine, Nutritional and Metabolic Diseases (E00-E89) (E00-E89)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E70-E88 — Metabolic disorders[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Referenced by Excludes1 notes
- P59 — Neonatal jaundice from other and unspecified causes[Excludes1](via E78.-): “jaundice due to inborn errors of metabolism (E70-E88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes2 notes (15)
- E88.0 — Disorders of plasma-protein metabolism, not elsewhere classified[Excludes2](via E78.-): “disorder of lipoprotein metabolism (E78.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- G11 — Hereditary ataxia[Excludes2](via E78.-): “metabolic disorders (E70-E88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- G71 — Primary disorders of muscles[Excludes2](via E78.-): “metabolic disorders (E70-E88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- N25.0 — Renal osteodystrophy[Excludes2](via E78.-): “metabolic disorders classifiable to E70-E88”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- N25.81 — Secondary hyperparathyroidism of renal origin[Excludes2](via E78.-): “metabolic disorders classifiable to E70-E88”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R70 — Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity[Excludes2](via E78.-): “abnormalities of lipids (E78.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79)[Excludes2](via E78.-): “abnormalities of lipids (E78.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R71 — Abnormality of red blood cells[Excludes2](via E78.-): “abnormalities of lipids (E78.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- and 7 more
Referenced by Code First instructions
- G63 — Polyneuropathy in diseases classified elsewhere[Code First](via E78.-): “metabolic diseases (E70-E88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- H42 — Glaucoma in diseases classified elsewhere[Code First](via E78.-): “specified metabolic disorder (E70-E88)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Clinical classification (CCSR)
- END010 — Disorders of lipid metabolism[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 642 — INBORN AND OTHER DISORDERS OF METABOLISM[MS-DRG]: “INBORN AND OTHER DISORDERS OF METABOLISM (MDC 10)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- MDC 10 — Endocrine, Nutritional and Metabolic Diseases and Disorders[MDC crossing]: “Endocrine, Nutritional and Metabolic Diseases and Disorders — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,008 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Index entries
- Elevated, elevation, lipoprotein alevel (Lp(a))[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Elevated, elevation, Lp (a) (lipoprotein(a))[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes (23)
- E78 — Disorders of lipoprotein metabolism and other lipidemias[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E78.0 — Pure hypercholesterolemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E78.00 — Pure hypercholesterolemia, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E78.01 — Familial hypercholesterolemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E78.010 — Homozygous familial hypercholesterolemia [HoFH][Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E78.011 — Heterozygous familial hypercholesterolemia [HeFH][Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E78.019 — Familial hypercholesterolemia, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- E78.1 — Pure hyperglyceridemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 15 more
Change history
- FY2019 — Added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2019
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "E78.41 — Elevated Lipoprotein(a)." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/e78.41-elevated-lipoproteina
Change history
- FY2019 — October 1, 2018Added to the code setElevated Lipoprotein(a)FY2019 changes
Nearest Codes in This Family
Official ICD-10-CM classifications closest to E78.41 in its code family, with their registry titles.
- E78.019 — Familial hypercholesterolemia, unspecified
- E78.1 — Pure hyperglyceridemia
- E78.2 — Mixed hyperlipidemia
- E78.3 — Hyperchylomicronemia
- E78.4 — Other hyperlipidemia
- E78.49 — Other hyperlipidemia
- E78.5 — Hyperlipidemia, unspecified
- E78.6 — Lipoprotein deficiency
- E78.7 — Disorders of bile acid and cholesterol metabolism
- E78.70 — Disorder of bile acid and cholesterol metabolism, unspecified