Coding Clinic 4th Quarter 2018 BMI

How are you all interpreting the Coding Clinic regarding BMI?  We have differing opinions in our organization and are trying to come to a consensus.

Are you interpreting this to mean - you can code the diagnosis (obesity, morbid obesity) BUT cannot report the BMI code unless it meets the definition of a secondary diagnosis (clinical evaluation, therapeutic treatment, diagnostic procedures, extended LOS, or increased nursing care/monitoring)?

Thanks!

Comments

  • No. Obesity is always clinically significant and should be coded if diagnosed/documented. If it is documented/captured, the BMI should also be captured.

    When other conditions that would also allow capture of BMI (overweight, malnutrition, anorexia, etc) are documented, they must meet reportability prior to either the BMI or the underlying condition can be coded.

    Katy

  • This is what Coding Clinic said to us on 10/26

     

    This letter is in response to your request for clarification regarding obesity and BMI coding.

     

    The Central Office has received many question about assigning BMI codes, therefore, updated advice was published in Coding Clinic Fourth Quarter 2018, pages 77-83. The advice clarifies that in order to assign a code for BMI, an associated clinical condition must be documented by the provider (i.e., morbid obesity, overweight, or obesity). It is not appropriate to assign a code for the BMI without an associated diagnosis. The advice further clarifies that obesity and morbid obesity are always clinically significant and reportable conditions that should be reported when documented by the provider.

     

    I trust that this information will be of assistance to you.

     

    Agree with what Katy just posted.

  • If it ‘impacts’ care, a condition is reportable.  If you were caring for a male that required hernia repair, how would it impact your care plan if your patient had a BMI of 25 versus a BMI of 41? Hence, it is ‘always’ reportable! 
  • If the BMI is documented but the associated diagnosis (obesity, morbid obesity, etc.) is not documented and there is no evidence in the medical record that the obesity impacted the care of the patient, would it be appropriate to query for the associated diagnosis? 

  • yes, as morbid obesity is always clinically significant.


    Katy

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