Hyperlipidemia is an umbrella term that refers to any of several acquired or genetic disorders that result in a high level of lipids (fats, cholesterol, and triglycerides) circulating in the blood. These lipids can enter the walls of arteries and increase your risk of developing atherosclerosis (hardening of the arteries), which can lead to stroke, heart attack, and the need to amputate. The risk of atherosclerosis is higher if you smoke, or if you have or develop diabetes, high blood pressure, and kidney failure.
More than 3 million people have this genetic disorder in the United States and Europe. It is extremely common for those who live in developed countries and follow a Western high-fat diet. Hyperlipidemia is usually chronic, requiring ongoing statin medication to control blood lipid levels.
Elevated blood lipid levels alone do not cause symptoms, except with pancreatitis (painful inflammation of the pancreas). However, if it results in coronary heart disease (CHD) or atherosclerosis, symptoms in adults can include chest pain or pressure (angina), blockage of blood vessels in the brain and heart, high blood pressure, heart attack, and stroke.
Treatment should begin with exercise, weight loss, a low-fat diet, and, if applicable, diabetes management. In most cases, though, more is needed. Anti-cholesterol medications (statins) is a medication that can be taken orally, usually, once a day, are extremely effective in lowering LDL and VLDL cholesterol levels. Success is monitored by periodic blood tests. The most common side effects leading to the stopping of a statin medication are intolerable muscle and joint aches. There are multiple FDA-approved statins, so trying a different one is usually suggested before giving up due to side effects. Statins may induce diabetes and cognitive dysfunction, risks that are far outweighed by the benefits of decreased morbidity and mortality from cardiovascular disease. If statins don’t work for you, due to side effects or insufficient results, as your physician about protein convertase subtilisin/Kexin type 9 (PCSK9) inhibitors. PCSK9 inhibitors appear to lower cholesterol levels 60% more than statins. While promising, these drugs are taken by injection, not orally, and can be very expensive. They are not yet recommended as first-line treatment for most people with hyperlipidemia but may be suitable for some. In very stubborn cases, a mechanical cleansing of the blood of lipids, called plasmapheresis, can help. This is an unusual treatment approach.
The table below includes the most commonly used ICD-10 codes for hyperlipidemia:
|ICD-10 Chapter||Codes||Code Description|
|4||E78.00||Pure hypercholesterolemia, unspecified|
|4||E78.6||High-density lipoprotein deficiency|
|4||E78.70||Disorder of bile acid and cholesterol metabolism, unspecified|
|4||E78.79||Other disorders of bile acid and cholesterol metabolism|
|4||E78.89||Other lipoprotein metabolism disorders|
|4||E78.9||Disorder of lipoprotein metabolism, unspecified|
Author: Tonoya Ahmed