ICD-10 Code for Elevated Lipoprotein(a)
Currently, there is no specific ICD-10 code for elevated lipoprotein(a) in the United States, which represents a significant gap in clinical documentation and research tracking. 1
Current Coding Limitations
The absence of a dedicated ICD-10 code for elevated Lp(a) creates several clinical challenges:
No standardized diagnostic code exists despite elevated Lp(a) affecting approximately 20-30% of the global population (over 1 billion people worldwide) and being a causal risk factor for cardiovascular disease 2
The NHLBI Working Group in 2018 specifically recommended supporting the assignment of an ICD-10 code for the diagnosis of elevated Lp(a), recognizing this as a critical unmet need 1
Why an ICD-10 Code Is Needed
The lack of a specific code has important clinical implications:
Prevents appropriate tracking of the prevalence of Lp(a) elevations in patient cohorts and establishment of large databases for clinical research 1
Limits identification of Lp(a) as a potential etiologic factor in patients with established cardiovascular disease 1
Impairs assignment of familial or genetic risk, particularly in younger patients with cardiovascular disease 1
Hinders clinical care planning as novel Lp(a)-lowering therapies emerge, making appropriate diagnosis, prognosis, and therapeutic assignment more difficult 1
Temporary Coding Workarounds
Until a specific code is assigned, clinicians may need to use:
E78.5 (Hyperlipidemia, unspecified) - though this is non-specific and doesn't capture the unique nature of elevated Lp(a)
E78.49 (Other hyperlipidemia) - slightly more specific but still inadequate for tracking Lp(a)-specific risk
Consider documenting elevated Lp(a) prominently in clinical notes with specific values (>30 mg/dL or >50 mg/dL depending on risk stratification) to ensure proper risk assessment even without a dedicated code 1, 3
Clinical Documentation Best Practices
While awaiting ICD-10 code assignment:
Document specific Lp(a) values in mg/dL or nmol/L in the medical record 1
Note the clinical context (premature CVD, familial hypercholesterolemia, recurrent events despite optimal therapy) that prompted Lp(a) measurement 3, 4
Record Lp(a) as a risk-enhancing factor when discussing cardiovascular risk stratification with patients 1