BMI Query

thicksthicks
edited May 2016 in Clinical & Coding
My question has to do with posting a physician query related to BMI.
Would it be considered leading to ask a physician to document BMI > 40
without a documented height? In the case I'm referencing, the patient
weighs more than 480 lbs. The documentation includes information such
as "cannot fit in scanner due to girth or size", "too obese for surgery"
and "super morbidly obese." Is it appropriate to ask for "BMI >40" as
opposed to having an actual measured number?



Thanks,



Tamara A. Hicks, RN, BSN, CCS, CCDS

Manager, Care Coordination

Certified Six Sigma Green Belt

North Carolina Baptist Hospital

Winston-Salem, NC

office: 336-713-4112

pager: 336-806-7709

fax: 336-716-1052

e-mail: thicks@wfubmc.edu


Comments

  • dallend@einstein.edudallend@einstein.edu
    edited May 2016
    Did dietary see the patient. When we query for BMI - usually the doctor will have someone get the height and/or wt - or they will ask the pt themselves.


  • cstukenbergcstukenberg
    edited May 2016
    I would think you would need a documented height and weight to accurately state what the BMI is. I would not want it to fall back on "assuming" it is over 40 just because the weight is 480.....even though it probably is. Even an estimated height along with the weight can help the dietician calculate the BMI which then gives you the documented BMI.
    Hope that helps.
    Thanks.
    Colleen


  • sbeattysbeatty
    edited May 2016
    I would be careful with that. While it's obvious the BMI is >40, you
    have asked the MD to document a finding related to a specific code. I
    would think a better approach is to cite the findings you've cited in
    your email, calculate the actual BMI (there are multiple online
    calculators you can use), and then explain that to assign the most
    specific codes to reflect severity of illness and resource consumption
    for patient care, you'd like their professional opinion if the actual
    BMI is appropriate to quantify the degree of morbid obesity. If so,
    please add the BMI to their progress notes or other documentation.



    How about something like that?



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    Sandy Beatty, RN, BSN, C-CDI

    Clinical Documentation Specialist

    Columbus Regional Hospital

    Columbus, IN

    (812) 376-5652

    sbeatty@crh.org



    "Obstacles are those frightful things you see when you take your eyes
    off the goal." Hannah More


  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    Ours captures overweight or underweight but we use a separate query for malnutrition

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404


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