Question: Can you code morbid obesity without BMI?

The treating provider must be the one to document obesity, morbid obesity, or any other diagnosis-related code from a BMI measurement. BMI codes should only be reported as a secondary diagnosis code.

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 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.

Can you code morbid obesity with BMI less than 40?

NIH defines morbid obesity as being 100 pounds or more above the ideal body weight; or having a BMI of 40 or greater; or having a BMI of 35 or greater and one or more comorbid conditions. Note that in the list above, there are no codes listed for a BMI of 35.0 to 39.9.

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Can obese be coded?

A coder can’t code a weight diagnosis based on BMI calculations, lab values or other measurements. Coders should use BMI codes only when there is an associated, reportable weight diagnosis, such as obesity. … However, BMI shouldn’t be coded unless the clinician documents the associated weight diagnosis.

Why would a claim be denied because of an obesity code?

**Review the carrier’s denial letter or explanation of benefits (EOB) for the reason for the denial. Most commonly provided reasons are due to bundling of services, or it is a carve out from the medical plan benefits or it is a non-covered service.

Is Class 3 obesity the same as morbid obesity?

What is morbid obesity (now known as class III obesity)? 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.

What is the ICD-10 code for exogenous obesity?

ICD-10-CM Diagnosis Code E66


What is exogenous obesity?

Exogenous or simple obesity is the result of maladjustments between food and exercise. Endogenous obesity is due to the lowered metabolism resulting from a disturbance in hypothalamic or endocrine functions, e. g., gonads, pituitary, or thyroid” (Best and Taylor,1 page 981).

Do you code BMI in pregnancy?

A: Interestingly, even though the physician may document that the patient is obese, based on the 2019 ICD-10-CM Official Guidelines for Coding and Reporting, BMI codes can’t be assigned for pregnant patients.

What is the BMI of E66 01?

9 if for BMIs 30-39 and E66. 01 is for BMIs>40. Can you clarify when to use each of these codes? A: The E codes E66.

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Can coders calculate the BMI?

Coding Guidance

ICD‐10‐CM Coding Guidelines, Section I.B. 14 states “The BMI codes should only be reported as secondary diagnoses.”5 Additionally, the patient’s BMI must be clearly documented as coders are not allowed to calculate BMI.

What is the consequence when a medical practice does not use diagnostic codes?

What is the consequence when a medical practice does not use diagnostic codes? Fines or penalties can be levied.

What type of code is assigned when the provider documents a reason for a patient seeking healthcare that is not injury or disease?

V codes, described in the ICD-9-CM chapter “Supplementary Classification of Factors Influencing Health Status and Contact with Health Services,” are designed for occasions when circumstances other than a disease or injury result in an encounter or are recorded by providers as problems or factors that influence care.