I am just wondering if anyone has a query for Obesit Hypoventilation Syndrome they wouldn't mind sharing with me. If so, my email address is jan.walden@chickasaw.net. Thank you!
I agree with you Dr Gold but we are having issues with coding feeling comfortable and I think it’s mainly due to the structure of the encoder and index/tabular. In the book to code OHS you start with obesity, underneath that you will not find hypoventilation (you will find hyperventilation). Hypobentilation is only found if you go hyperventilation-->morbid-->with alveolar hypoventilation. So you have to have the ‘morbid’ classification first in order to get there. And these patients with a BMI in-between 30-40 are not being stated by our physicians as having morbid/severe obesity. It’s the same in the encoder (3M), we start with hypoventilation and the next screen looks like this: [cid:image001.png@01D10CB5.E0350500]
They don’t feel comfortable coding that when morbid has not been stated and the BMI is under 40. I understand this concern but clinically these patients do have OHS.
Interestingly enough, if the provider states ‘pickwickian’, we do not have this issue because this eliminates the issue in the encoder. However, this is not the terminology we have promoted up until this point and so it tends not to be what physicians are using.
Have any other hospitals run into this issue?
Katy Good, RN, BSN, CCDS, CCS Clinical Documentation Program Coordinator AHIMA Approved ICD-10CM/PCS Trainer Flagstaff Medical Center Kathryn.Good@nahealth.com Cell: 928.814.9404
I just re-read this and realized that I mixed up hyperventilation and hypoventilation a couple times which makes it pretty confusing. I apologize. My issue is with obesity HYPOventilation syndrome. Obesity hypoventilation syndrome is only available in the encoder and book under the classification of ‘morbid’. This is not true for Hyperventilation.
[cid:image002.png@01D10CB8.BC642310]
Sorry for the confusion.
Katy Good, RN, BSN, CCDS, CCS Clinical Documentation Program Coordinator AHIMA Approved ICD-10CM/PCS Trainer Flagstaff Medical Center Kathryn.Good@nahealth.com Cell: 928.814.9404
Both “obesity hypoventilation syndrome” and “Pickwick(ian) syndrome” get you the same code. The title of a code is the bane of valid coding. Coding professionals are frequently rigid regarding coding a word rather than coding a disease because they are trained that way. OHS is the terminology in the medical world. There are many other examples of this in the coding world and in the encoder software. Sometimes you win, sometimes you wait for it to be fixed. You should never lose – if you’re right.
Robert S. Gold, MD CEO, DCBA, Inc 4611 Brierwood Place Atlanta, GA 30360 (770) 216-9691 (Office) (404) 580-0204 (Cell)
Hi starting with syndrome. When I type hypo ventilation. 3m ONLY gives hypo ventilation,congenital central alveolar...that's not right? Can not do with JATA software either.
That’s what we are finding also. In 3M, you need to start with hypoventilation which will then give you the choice of “morbid (severe) obesity with alveolar hypoventilation”
You can’t get there if you start with ‘syndrome’ in I-10. At least not in the 3M or in the index that I can see. This is the issue, the coding path has changed. You must start with hypoventilation to get to OHS. I understand that clinically ‘pickwickian’ and OHS are the same and that they can occur in patients with a BMI under 40. My issue is that with the way the index and encoder currently work they route you to morbid obesity first and our coders are therefore not comfortable coding this in a patient without ‘morbid’ obesity. I understand their concern and can definitely see this being denied by auditors as well. Clinically, that makes no sense but we know that often ‘reality’ is not a factor auditors take into consideration ;-).
Thanks for all your help,
Katy Good, RN, BSN, CCDS, CCS Clinical Documentation Program Coordinator AHIMA Approved ICD-10CM/PCS Trainer Flagstaff Medical Center Kathryn.Good@nahealth.com Cell: 928.814.9404
What's interesting is that if you select "morbid obesity with alveolar hypoventilation" in 3M, the next screen allows you to select a BMI anywhere between 19 and 70....
The definitions listed in that article do not match our Hospital preferred reference, UpToDate: "The morbidity and mortality associated with being overweight or obese have been known to the medical profession since the time of Hippocrates more than 2500 years ago. Overweight refers to a weight above the "normal" range, with normal defined on the basis of actuarial data. This is determined by calculating the body mass index (BMI, defined as the weight in kilograms divided by height in meters squared). Overweight is defined as a BMI of 25 to 29.9 kg/m2; obesity is defined as a BMI of ≥30 kg/m2. Severe obesity is defined as a BMI ≥40 kg/m2 (or ≥35 kg/m2 in the presence of comorbidities)."
Classification of BMI — BMI classifications are based upon risk of CVD [16]. The recommended classifications for BMI adopted by the National Institute of Health (NIH) and World Health Organization (WHO) [19,20] for Caucasian, Hispanic, and Black individuals are:
●Underweight – BMI Hi starting with syndrome. When I type hypo ventilation. 3m ONLY gives > hypo ventilation,congenital central alveolar...that's not right? Can > not do with JATA software either. >
That’s 3-M for you. They depend on a word, not a disease. The software I use gets you where you should go directly. Oh, well. Maybe 3-M can grow up. ☺ It’s always possible!
Robert S. Gold, MD CEO, DCBA, Inc 4611 Brierwood Place Atlanta, GA 30360 (770) 216-9691 (Office) (404) 580-0204 (Cell)
Here is something to consider…when facing such issues, bear in mind the instructions and sequencing directions in the published and current ICD-CM-10 Guidelines and Coding Reference always take precedence. So, research this in the written and official code books and references and follow those instructions. Sometimes there are ‘errors’ of logic used in some of the software groupers that may lead to improper coding assignments. If we find our software logic is not the same as per the books, the vendor should notified of the error, and the official published guidelines are to be followed.
Paul
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity Sutter West Bay 633 Folsom St., 7th Floor, Office 7-044 San Francisco, CA 94107 Cell: 415.412.9421
I agree Paul, but it looks to me that in this case, 3M matches the book. Do you agree? What would you do as a coder in this scenario. Code or not code?
Thanks!
Katy Good, RN, BSN, CCDS, CCS Clinical Documentation Program Coordinator AHIMA Approved ICD-10CM/PCS Trainer Flagstaff Medical Center Kathryn.Good@nahealth.com Cell: 928.814.9404
I really do think it’s a typographical error in the index book under obesity—‘with alveolar hyperventilation should be hypoventilation.
[cid:image002.png@01D10CC2.432A00F0]
Here we are changing our educational tools to all say morbid obesity w/ alveolar hypoventilation instead of OHS. Can’t see a way to code from just the OHS term alone. Janice
Hi, Katy. I don’t know as we’ve not had that come up yet so I’m finding this conversation very interesting. My fear is that the way that is worded (“morbid-severe”) and if the BMI did not match it could be denied.
Without the encoder I have the same issue. Hypoventilation is listed under obesity, but under the sub-heading of ‘morbid’. Since we don’t have documentation of ‘morbid’ obesity, our coders are not comfortable coding this.
I have submitted this question to Coding Clinic.
Katy Good, RN, BSN, CCDS, CCS Clinical Documentation Program Coordinator AHIMA Approved ICD-10CM/PCS Trainer Flagstaff Medical Center Kathryn.Good@nahealth.com Cell: 928.814.9404
Obesity hypoventilation syndrome is defined as obesity with restrictive lung disease causing secondary pulmonary hypertension. Cardiopulmonary obesity is a synonym. Pickwickian syndrome is a synonym . The code for all of these is E66.2. It doesn’t matter what the words in the code description are. In ICD-9, nobody complained or balked, not because the term “morbid obesity” wasn’t in the title of the code – because that was the code for the disease. It’s still the code for the disease. This diversion of truth because of the word “morbid” or the word “alveolar” is just dumb and getting everybody guessing and people are spinning their wheels. E66.2 is the code for OHS. As was mentioned earlier in a quote from ICD10Data.com:
Clinical Information
* Hypoventilation syndrome in very obese persons with excessive adipose tissue around the abdomen and diaphragm. It is characterized by diminished to absent ventilatory chemoresponsiveness; chronic hypoxia; hypercapnia; polycythemia; and long periods of sleep during day and night (hypersomnolence). It is a condition often related to obstructive sleep apnea but can occur separately. Applicable To
* Pickwickian syndrome Description Synonyms
* Extreme obesity with alveolar hypoventilation * Obesity hypoventilation syndrome It’s E66.2. The overindulgence on a word makes no sense. It’s just a title. The intent of the code is what counts. Ask NCHS and AHIMA. It’s the intent of the code. E66.2 is for OHS.
Robert S. Gold, MD CEO, DCBA, Inc 4611 Brierwood Place Atlanta, GA 30360 (770) 216-9691 (Office) (404) 580-0204 (Cell)
I absolutely agree with your clinical knowledge and descriptions here. The issue is that coders are tasked with coding the words the providers use. They are not supposed to delve into the diagnosing. If the words used don’t index to E66.2 I don’t know how to resolve this with a coding professional.
If the documentation does not index to the code set, the condition can’t be coded This seems like another situation whereby the code and descriptions offered in I-10 are not congruent with clinical reality. The issue should be sent to AHA for resolution. From the discussion, it seems that the description of the obesity as morbid should be included in be in parentheses per the index…this would make the designation of the obesity as ‘morbid’ a ‘nonessential modifier’.
[cid:image003.png@01D10CD1.14FF0310]
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity Sutter West Bay 633 Folsom St., 7th Floor, Office 7-044 San Francisco, CA 94107 Cell: 415.412.9421
Thank you for understanding the lack of thought process by some; however, when the code for the disease was first invented, Coding Clinic discussed it as follows:
Coding Clinic, Fourth Quarter 2010 Page: 80 Effective with Discharges: October 1, 2010
Effective October 1, 2010, a new code has been created to uniquely identify obesity hypoventilation syndrome (278.03).
In obesity hypoventilation syndrome (OHS), breathing problems cause chronic hypoventilation, which manifests with decreased oxygen levels and elevated carbon dioxide levels. OHS is also called Pickwickian syndrome. It involves sleep-disordered breathing. The breathing problems may be related to both obesity and to neurological issues.
Many people with this condition also frequently stop breathing for short periods of time during sleep, causing partial awakenings during the night, which leads to sleepiness during the day. The disease puts pressure on the heart, which eventually may lead to symptoms of heart failure. Weight loss is beneficial.
278 Overweight, obesity and other hyperalimentation
278.0 Overweight and obesity
New code 278.03 Obesity hypoventilation syndrome Pickwickian syndrome
Question:
A morbidly obese patient is admitted with increased shortness of breath. Patient reports awakening frequently during the night and increased sleepiness during the day. The dietitian noted that the patient’s body mass index was 44 and recommended a weight loss program. The provider’s final diagnosis recorded “obesity hypoventilation syndrome, morbid obesity.” What is the appropriate diagnosis code assignment for “obesity hypoventilation syndrome?”
Answer:
Assign code 278.03, Obesity hypoventilation syndrome, as the principal diagnosis. Codes 278.01, Morbid obesity, and V85.4, Body mass index 40 and over, adult, should also be assigned. It is appropriate to separately assign code 278.01, Morbid obesity, if desired, since it provides further information on severity, and may not necessarily be inherent. It is possible for an individual to have obesity hypoventilation syndrome when they are not morbidly obese.
Prior to this, it was discussed at the Coordination and Maintenance Committee in September 2009 when it was adopted, and it read:
In obesity hypoventilation syndrome (OHS), breathing problems cause chronic hypoventilation, that manifests with decreased oxygen levels and elevated carbon dioxide levels. OHS is also called Pickwickian syndrome. It involves sleep disordered breathing. The breathing problems may be related to both obesity and to neurological issues. Weight loss is beneficial.
While other codes may be assigned for the sleep disordered breathing, notes to require a particular code ordering are not being proposed.
TABULAR MODIFICATIONS
278 Overweight, obesity and other hyperalimentation
278.0 Overweight and obesity
New code 278.03 Obesity hypoventilation syndrome Pickwickian syndrome
At that time, it was Obesity hypoventilation syndrome with alternate terminology of Pickwickian syndrome. If you look at the crossover from ICD-9 to ICD-10, this maps directly to E66.2 by GEMS. Crosswalk Information ICD-10 Code
ICD-9 Code
ICD-9 Description
E66.2
[Right Arrow]
278.03
Obesity hypovent synd
This ICD-10 to ICD-9 data is based on the 2015 General Equivalency Mapping (GEM) files published by the Centers for Medicare & Medicaid Services (CMS) for informational purposes only. The data is not an ICD-10 conversion tool and doesn’t guarantee clinical accuracy.
Please forgive me if this has already been covered in this thread, but I have a question regarding OHS.
Physician documents OHS in the progress notes daily. BMI is 30 which is just obesity in this patient. In I-10 the code verbiage contains Morbidly Obese. This patient is not Morbidly Obese. And criteria for OHS is not met.
Should we only code Obesity and not OHS as the patient does not meet criteria? Or query...and how would you query?
The Maintenance and Coordination Committee should revise the Index so that the term "morbid" is a non-essential modifier. This would eliminate some of the confusion, in my opinion.
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity Sutter West Bay 633 Folsom St., 7th Floor, Office 7-044 San Francisco, CA 94107 Cell: 415.412.9421
Always a problem with overdocumentation when no criteria are met. Patients can have OHS without meeting morbid obesity criteria so long as the restrictive lung disease from the patient's obesity, whatever level it is, has caused sufficient lung issues to lead to chronic cor pulmonale or pulmonary hypertension. If the patient does have this, then it should be eligible for the code. If there is not sufficient evidence in the medical record, then I'd ask the doc for the evidence that links chronic pulmonary heart disease to the obesity state. Sometimes a patient may have lost considerable weight with diet and exercise or surgery or unintended weight loss due to disease, but the cardiopulmonary effect still exists. Gotta check all of these with the records and get clarification from the doc if the evidence isn't there. Let us know what you find.
Robert S. Gold, MD CEO, DCBA, Inc 4611 Brierwood Place Atlanta, GA 30360 (770) 216-9691 (Office) (404) 580-0204 (Cell)
I guess that is my underlying question. I'm used to seeing OHS in patients with Chronic Lung disease. (COPD). I did not see where the doc documented a chronic Lung Condition. I instructed the Coder to capture the Obesity and move on.
But the verbiage does need to change or include (with or without documented morbid obesity) language excluding the Morbid Obesity.
Comments
[cid:image001.png@01D10CB5.E0350500]
They don’t feel comfortable coding that when morbid has not been stated and the BMI is under 40. I understand this concern but clinically these patients do have OHS.
Interestingly enough, if the provider states ‘pickwickian’, we do not have this issue because this eliminates the issue in the encoder. However, this is not the terminology we have promoted up until this point and so it tends not to be what physicians are using.
Have any other hospitals run into this issue?
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
[cid:image002.png@01D10CB8.BC642310]
Sorry for the confusion.
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
Robert S. Gold, MD
CEO, DCBA, Inc
4611 Brierwood Place
Atlanta, GA 30360
(770) 216-9691 (Office)
(404) 580-0204 (Cell)
Linda
Linda Haynes, RHIT, CCDS | Manager, Clinical Documentation (CDI/CCCA) | Legacy Health
19300 SW 65th Ave. | Tualatin, Oregon 97062 | 503-692-8862 | lhaynes@lhs.org
look at this article from last year - they list
30.0 -35.9 Severe Obesity
Class I Obesity
36.0 – 39.99 Morbid Obesity
Class II Obesity
40.0 and above Super Obesity
Class III Obesity
http://www.hcpro.com/content.cfm?content_id=306189
Thanks!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
I understand that clinically ‘pickwickian’ and OHS are the same and that they can occur in patients with a BMI under 40. My issue is that with the way the index and encoder currently work they route you to morbid obesity first and our coders are therefore not comfortable coding this in a patient without ‘morbid’ obesity. I understand their concern and can definitely see this being denied by auditors as well. Clinically, that makes no sense but we know that often ‘reality’ is not a factor auditors take into consideration ;-).
Thanks for all your help,
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
The definitions listed in that article do not match our Hospital preferred reference, UpToDate:
"The morbidity and mortality associated with being overweight or obese have been known to the medical profession since the time of Hippocrates more than 2500 years ago. Overweight refers to a weight above the "normal" range, with normal defined on the basis of actuarial data. This is determined by calculating the body mass index (BMI, defined as the weight in kilograms divided by height in meters squared). Overweight is defined as a BMI of 25 to 29.9 kg/m2; obesity is defined as a BMI of ≥30 kg/m2. Severe obesity is defined as a BMI ≥40 kg/m2 (or ≥35 kg/m2 in the presence of comorbidities)."
http://www.uptodate.com/contents/obesity-in-adults-overview-of-management?source=search_result&search=morbid+obesity&selectedTitle=1~150
Classification of BMI — BMI classifications are based upon risk of CVD [16]. The recommended classifications for BMI adopted by the National Institute of Health (NIH) and World Health Organization (WHO) [19,20] for Caucasian, Hispanic, and Black individuals are:
●Underweight – BMI Hi starting with syndrome. When I type hypo ventilation. 3m ONLY gives
> hypo ventilation,congenital central alveolar...that's not right? Can
> not do with JATA software either.
>
Robert S. Gold, MD
CEO, DCBA, Inc
4611 Brierwood Place
Atlanta, GA 30360
(770) 216-9691 (Office)
(404) 580-0204 (Cell)
Paul
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
Thanks!
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
[cid:image002.png@01D10CC2.432A00F0]
Here we are changing our educational tools to all say morbid obesity w/ alveolar hypoventilation instead of OHS. Can’t see a way to code from just the OHS term alone.
Janice
Janice Schoonhoven RN, MSN, CCDS | Manager | Clinical Documentation Integrity
PeaceHealth | 3333 Riverbend Dr. | Springfield, OR 97477
office 541-222-5348 | fax 541-222-2427 | efax 541-335-2347
And we have also added the terminology of ‘alveolar’ as well ☺
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
Linda
Linda Haynes, RHIT, CCDS | Manager, Clinical Documentation (CDI/CCCA) | Legacy Health
19300 SW 65th Ave. | Tualatin, Oregon 97062 | 503-692-8862 | lhaynes@lhs.org
I have submitted this question to Coding Clinic.
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
Clinical Information
* Hypoventilation syndrome in very obese persons with excessive adipose tissue around the abdomen and diaphragm. It is characterized by diminished to absent ventilatory chemoresponsiveness; chronic hypoxia; hypercapnia; polycythemia; and long periods of sleep during day and night (hypersomnolence). It is a condition often related to obstructive sleep apnea but can occur separately.
Applicable To
* Pickwickian syndrome
Description Synonyms
* Extreme obesity with alveolar hypoventilation
* Obesity hypoventilation syndrome
It’s E66.2. The overindulgence on a word makes no sense. It’s just a title. The intent of the code is what counts. Ask NCHS and AHIMA. It’s the intent of the code. E66.2 is for OHS.
Robert S. Gold, MD
CEO, DCBA, Inc
4611 Brierwood Place
Atlanta, GA 30360
(770) 216-9691 (Office)
(404) 580-0204 (Cell)
Janice
Janice Schoonhoven RN, MSN, CCDS | Manager | Clinical Documentation Integrity
PeaceHealth | 3333 Riverbend Dr. | Springfield, OR 97477
office 541-222-5348 | fax 541-222-2427 | efax 541-335-2347
[cid:image003.png@01D10CD1.14FF0310]
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
Obesity Hypoventilation Syndrome (Pickwickian Syndrome)
Coding Clinic, Fourth Quarter 2010 Page: 80
Effective with Discharges: October 1, 2010
Effective October 1, 2010, a new code has been created to uniquely identify obesity hypoventilation syndrome (278.03).
In obesity hypoventilation syndrome (OHS), breathing problems cause chronic hypoventilation, which manifests with decreased oxygen levels and elevated carbon dioxide levels. OHS is also called Pickwickian syndrome. It involves sleep-disordered breathing. The breathing problems may be related to both obesity and to neurological issues.
Many people with this condition also frequently stop breathing for short periods of time during sleep, causing partial awakenings during the night, which leads to sleepiness during the day. The disease puts pressure on the heart, which eventually may lead to symptoms of heart failure. Weight loss is beneficial.
278 Overweight, obesity and other hyperalimentation
278.0 Overweight and obesity
New code 278.03 Obesity hypoventilation syndrome
Pickwickian syndrome
Question:
A morbidly obese patient is admitted with increased shortness of breath. Patient reports awakening frequently during the night and increased sleepiness during the day. The dietitian noted that the patient’s body mass index was 44 and recommended a weight loss program. The provider’s final diagnosis recorded “obesity hypoventilation syndrome, morbid obesity.” What is the appropriate diagnosis code assignment for “obesity hypoventilation syndrome?”
Answer:
Assign code 278.03, Obesity hypoventilation syndrome, as the principal diagnosis. Codes 278.01, Morbid obesity, and V85.4, Body mass index 40 and over, adult, should also be assigned. It is appropriate to separately assign code 278.01, Morbid obesity, if desired, since it provides further information on severity, and may not necessarily be inherent. It is possible for an individual to have obesity hypoventilation syndrome when they are not morbidly obese.
Prior to this, it was discussed at the Coordination and Maintenance Committee in September 2009 when it was adopted, and it read:
Obesity hypoventilation syndrome (Pickwickian syndrome)
In obesity hypoventilation syndrome (OHS), breathing problems cause chronic hypoventilation, that manifests with decreased oxygen levels and elevated carbon dioxide levels. OHS is also called Pickwickian syndrome. It involves sleep disordered breathing. The breathing problems may be related to both obesity and to neurological issues. Weight loss is beneficial.
While other codes may be assigned for the sleep disordered breathing, notes to require a particular code ordering are not being proposed.
TABULAR MODIFICATIONS
278 Overweight, obesity and other hyperalimentation
278.0 Overweight and obesity
New code 278.03 Obesity hypoventilation syndrome
Pickwickian syndrome
At that time, it was Obesity hypoventilation syndrome with alternate terminology of Pickwickian syndrome. If you look at the crossover from ICD-9 to ICD-10, this maps directly to E66.2 by GEMS.
Crosswalk Information
ICD-10 Code
ICD-9 Code
ICD-9 Description
E66.2
[Right Arrow]
278.03
Obesity hypovent synd
This ICD-10 to ICD-9 data is based on the 2015 General Equivalency Mapping (GEM) files published by the Centers for Medicare & Medicaid Services (CMS) for informational purposes only. The data is not an ICD-10 conversion tool and doesn’t guarantee clinical accuracy.
Many other organizations agree and use this code for OHS: https://www.sleepassociation.org/sleep-disorders-icd-10-codes-names/
Classification and external resources
Specialty
endocrinology
ICD-10
E66.2
ICD-9-CM
278.03
OMIM
257500
DiseasesDB
32243
MedlinePlus
000085
eMedicine
ped/1627 med/3470
MeSH
D010845
But some people just don’t get it. Huh?
Robert S. Gold, MD
CEO, DCBA, Inc
4611 Brierwood Place
Atlanta, GA 30360
(770) 216-9691 (Office)
(404) 580-0204 (Cell)
Robert S. Gold, MD
CEO, DCBA, Inc
4611 Brierwood Place
Atlanta, GA 30360
(770) 216-9691 (Office)
(404) 580-0204 (Cell)
Thank you.
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
And for everybody else, too.
Robert S. Gold, MD
CEO, DCBA, Inc
4611 Brierwood Place
Atlanta, GA 30360
(770) 216-9691 (Office)
(404) 580-0204 (Cell)
Please forgive me if this has already been covered in this thread, but I have a question regarding OHS.
Physician documents OHS in the progress notes daily. BMI is 30 which is just obesity in this patient. In I-10 the code verbiage contains Morbidly Obese. This patient is not Morbidly Obese. And criteria for OHS is not met.
Should we only code Obesity and not OHS as the patient does not meet criteria? Or query...and how would you query?
Thank you,
Norma Brunson, BS, RHIA,CDIP,CCS,CCDS.
Paul Evans, RHIA, CCS, CCS-P, CCDS
Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
633 Folsom St., 7th Floor, Office 7-044
San Francisco, CA 94107
Cell: 415.412.9421
evanspx@sutterhealth.org
Robert S. Gold, MD
CEO, DCBA, Inc
4611 Brierwood Place
Atlanta, GA 30360
(770) 216-9691 (Office)
(404) 580-0204 (Cell)
But the verbiage does need to change or include (with or without documented morbid obesity) language excluding the Morbid Obesity.
Thank you!