Can You Code Morbid Obesity Without BMI?

by | Last updated on January 24, 2024

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Can you code morbid obesity without BMI? For patients with provider documentation identifying “morbid” obesity, the code E66. 01 (morbid [severe] obesity due to excess calories) can be assigned even if the BMI is not greater than 40 , per the Coding Clinic.

Can obesity be coded without BMI?

Coding Clinic has addressed this topic over the years, noting that BMI should not be coded without an associated diagnosis such as overweight or obesity.

How do you file morbid obesity?

Code the provider diagnosis, regardless of documented BMI. – e.g., Provider documents obesity with a BMI of 45, then obesity would be abstracted. – e.g., A BMI of 32.9 is noted, the provider documents morbid obesity, then morbid obesity should be abstracted with no query .

How do you code obesity in ICD-10?

Code E66* is the diagnosis code used for Overweight and Obesity. It is a disorder marked by an abnormally high, unhealthy amount of body fat. Excess body weight can come from fat, muscle, bone, and/or water retention.

Can obesity be a primary diagnosis?

However, obesity is a chronic disease that is underdiagnosed in clinical practice. Fewer than 30% of adults with obesity are thought to receive the diagnosis during their primary care visit .

When can I code morbid obesity?

For patients with provider documentation identifying “morbid” obesity, the code E66. 01 (morbid [severe] obesity due to excess calories) can be assigned even if the BMI is not greater than 40 , per the Coding Clinic.

Is morbid obesity a CC?

A: The diagnosis of morbid or severe obesity alone is not a CC . The addition of the body mass index (BMI) greater than 40 is the CC. The BMI, however, cannot be captured by coding unless there is an accompanying diagnosis which would be the morbid or severe obesity.

What is the ICD 10 CM code for morbid obesity due to excess calories?

ICD-10 code E66. 01 for Morbid (severe) obesity due to excess calories is a medical classification as listed by WHO under the range – Endocrine, nutritional and metabolic diseases .

How is obesity charted?

  1. If your BMI is less than 18.5, it falls within the underweight range.
  2. If your BMI is 18.5 to <25, it falls within the healthy weight range.
  3. If your BMI is 25.0 to <30, it falls within the overweight range.
  4. If your BMI is 30.0 or higher, it falls within the obesity range.

How do you say a patient is overweight?

Obese patients from six diverse primary care practices rated the terms “fatness,” “excess fat,” “large size,” and “heaviness” as undesirable for describing excess weight.

What is the ICD-10 code for morbid obesity?

E66. 01 is morbid (severe) obesity from excess calories.

What is the most common measurement used to code for obesity?

The most basic method, and the most common, is the body mass index (BMI) .

When do you use Z71 89?

ICD-10 code Z71. 89 for Other specified counseling is a medical classification as listed by WHO under the range – Factors influencing health status and contact with health services .

Can you bill for obesity?

At the 6-month visit, a reassessment of obesity and a determination of the amount of weight loss must be documented in the health care record . Obesity screening and counseling is one of a number of distinct preventive services mandated by national and state regulations [US Dept. of Labor].

What BMI is considered morbid obesity?

Defining Obesity

Individuals are usually considered morbidly obese if their weight is more than 80 to 100 pounds above their ideal body weight. A BMI above 40 indicates that a person is morbidly obese and therefore a candidate for bariatric surgery.

What is the new term for obesity?

In a new position statement, the American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have replaced the word “obesity” with “ Adiposity-Based Chronic Disease ” (ABCD).

How do you code obesity and BMI?

Never report BMI codes during pregnancy. Assign a code from 099.21- Obesity complicating childbirth, with the specific obesity/morbid obesity code from category E66 Overweight and obesity , as appropriate.

Can coders calculate the BMI?

The coder cannot under any circumstance calculate the BMI , however in the coding guidelines it will tell you that the coder may obtain the documentation of the BMI from any qualified medical person and it does not have to come from the physician , so a nurse or PT, or nutitionist is fine.

What is the difference between obese and morbidly obese?

Obesity, having too much body fat, is defined as having a body mass index (BMI) of greater than 30. BMI is a measure of your weight relative to your height. Morbid obesity, which is also termed “clinically severe obesity,” is typically defined as being more than 100 pounds overweight or having a BMI of 40 or higher.

Can E66 01 be a primary diagnosis?

Report the primary diagnosis as E66. 01 , then an additional secondary diagnosis for body mass index (BMI) and a third diagnosis for the comorbidities as appropriate.

What is the definition of super morbid obesity?

Super morbidly obese is a term that was proposed by Mason in 1987 to describe patients with a weight equal to or greater than 225% of ideal bodyweight . Lean bodyweight is total bodyweight minus the weight of body fat.

What is the ICD-10-CM code for morbid obesity with a BMI of 44 in an adult male?

ICD-10 code Z68. 4 for Body mass index [BMI] 40 or greater, adult is a medical classification as listed by WHO under the range – Factors influencing health status and contact with health services .

What is morbid severe obesity due to excess calories?

Class III obesity, formerly known as morbid obesity, is a complex chronic disease in which a person has a body mass index (BMI) of 40 or higher or a BMI of 35 or higher and is experiencing obesity-related health conditions .

How is obesity Class 2 coded?

  1. Overweight – BMI 25.0-29.9.
  2. Class 1 – BMI 30.0-34.9.
  3. Class 2 – BMI 35.0-39.9.
  4. Class 3 – BMI > = 40.0.

What are the three levels of obesity and how are they classified?

Overweight (not obese), if BMI is 25.0 to 29.9. Class 1 (low-risk) obesity, if BMI is 30.0 to 34.9. Class 2 (moderate-risk) obesity, if BMI is 35.0 to 39.9. Class 3 (high-risk) obesity, if BMI is equal to or greater than 40.0.

What measurement helps determine a patient’s level of obesity?

BMI is a useful measure of overweight and obesity. It is calculated from your height and weight. BMI is an estimate of body fat and a good gauge of your risk for diseases that can occur with more body fat.

What is clinical obesity?

Experts use BMI (body mass index) to tell if people are a few pounds heavier than they ought to be or if they are clinically obese. Doctors consider a person to be clinically obese if he or she weighs at least 100 pounds over what is considered an ideal weight for a person’s height .

What weight is classified as bariatric?

Obesity is classified using the body mass index (BMI), in which weight (kg) is divided by height squared (m2). For the purpose of this guideline, ‘bariatric’ refers to all patients assessed as being heavier than 158 KG (25 Stone) stone or with a body mass index BMI above (>40kg/m2) .

What is diagnosis code Z71 3?

What is more accurate than BMI?

While BMI is a rough estimate of body fat, body fat percentage is a more accurate number. BMI, but not overfat. Likewise, a person of normal weight on the BMI scales may still be overfat and at risk of weight-related diseases.

Is the BMI chart outdated?

Though it has been used for decades as the go-to measurement for health based on body size, it has been widely criticized for its oversimplification of what being healthy really means. In fact, many claim BMI is outdated and inaccurate and shouldn’t be used in medical and fitness settings.

What is ICD-10 code for weight loss?

Can Z76 89 be a primary diagnosis?

The patient’s primary diagnostic code is the most important . Assuming the patient’s primary diagnostic code is Z76. 89, look in the list below to see which MDC’s “Assignment of Diagnosis Codes” is first. That is the MDC that the patient will be grouped into.

Is Z76 89 a billable code?

Z76. 89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

What diagnosis codes Cannot be primary?

Diagnosis Codes Never to be Used as Primary Diagnosis

With the adoption of ICD-10, CMS designated that certain Supplementary Classification of External Causes of Injury, Poisoning, Morbidity (E000-E999 in the ICD-9 code set) and Manifestation ICD-10 Diagnosis codes cannot be used as the primary diagnosis on claims.

Can you bill for obesity?

At the 6-month visit, a reassessment of obesity and a determination of the amount of weight loss must be documented in the health care record . Obesity screening and counseling is one of a number of distinct preventive services mandated by national and state regulations [US Dept. of Labor].

Carlos Perez
Author
Carlos Perez
Carlos Perez is an education expert and teacher with over 20 years of experience working with youth. He holds a degree in education and has taught in both public and private schools, as well as in community-based organizations. Carlos is passionate about empowering young people and helping them reach their full potential through education and mentorship.