Morbid Obesity with BMI >35-39.9

Good morning,

Do you code/query/educate medical practitioners around the coding guideline below:

Report a code from Z68-Z68.29 with E66.01 Morbid (sever) obesity due to excess calories, if BMI equal/greater than 35-39.9 with a  related comorbidity (for example, DM, HTN, COPD, etc.) with support documentation of the comorbid conditions.

This is especially important for  Risk Adjustment.  Thank you in advance for your time and appreciate your thoughts.


Regards

Tracy Boldt



Comments

  • Hi Tracy,

    Yes, we educate providers to document morbid/severe obesity and document the related condition.

    Katy

  • Thank  you, Katie! The BMI >35-39.9 (w/chronic conditions) appears to be the concept our practitioners are having difficulty with.  Traditional CDI programs educated the BMI >40 only, with MO to capture the traditional CC.  Health care is always moving and important we keep up.

    As always, appreciate your feedback. 

    Tracy

  • Our organization has always used the >40 guideline.  Would you share the details of this coding guideline?  I was not able to find it during my (admittedly brief) search.

    Thanks,

    Laura

  • Hi Laura,

    Attached are 2 excellent resources to you are welcome to utilize regarding MO w/BMI 35-39.9.  An actual coding guideline, you are right is tough to obtain.  However based on what the payer, CMS, WHO and the Bariatric Surgery for Morbid Obesity, I recommend facilities move in the same direction.

  • An additional resource.

    Regards,

    Tracy Boldt

  • coding is based off of MD documentation, so severe/morbid obesity should be coded when providers document it. The bigger issue is the definition of morbid/severe obesity. The BMI 35+ with related comorbidity definition comes from the WHO (though others have adopted).

    This is really an issue of MD education, not coding guidelines (IMO).


    Katy

  • Tracy,

    Thank you so much!  As far as the related comorbidities are concerned, it there a list or is it just what clinically makes sense?

    Thanks,

    Laura

  • to the best of my knowledge there is no full list anywhere that you could go and copy, but any comorbid condition where the excess weight would compromise a patients health such as heart disease, stroke, diabetes, musculoskeletal and some types of cancer would be included

  • Happy Friday Laura,

    We developed an approved list internally (HTN, DM, OSA, Hyperlipidemia). 

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