2019 code guideline BMI /Pregnancy

mlbuntzemlbuntze
in Denials
Due to the recent update and the article in AHIMA , the coders are wanting to remove the dx: obesity/w BMI.  It appears to me that based on the article AHIMA is conflicted and is looking towards the coding clinic response. Our facility only captures the medical diagnosis /w BMI in pregnant patient. We do not capture the BMI unless it has an associated dx (obesity, excessive wt gain, morbid obesity.)  Are other facilities experiencing this.  
thanks Marjie CDI- texas

http://journal.ahima.org/2018/09/12/fy-2019-icd-10-code-changes-overview/

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  • lprescott1lprescott1
    AHA Coding Clinic, 4th Quarter 2018, page 80
    "do not assign codes for the body mass index (BMI) during pregnancy. Assign only code O99.214, Obesity complicating childbirth, with the specific obesity code from category E66-, Overweight and obesity, for obesity complicating delivery. Weight gain during pregnancy is evaluated differently, and is based on the mother’s BMI before the pregnancy. Please note that effective October 1, 2018, the Official Guidelines for Coding and Reporting for BMI codes have been revised. The revised guideline states, “Do not assign BMI codes during pregnancy.”

  • mlbuntzemlbuntze

    Thank you for your response.  I do see and understand the updated guideline. I just would like to identify that if you go to the actual chapters that there is no exclusion and that it still suggests the BMI additional code.  I have found that  on certain cases the addition of the BMI does raise the SOI.  We are following the 2019 guideline of not coding, just thought that was interesting.

    thank you MB 

  • lprescott1lprescott1
    I am not sure what you are referring to- if you look under the o99.21 code grouping within the code book- there is no use additional code note - instructing you to also add the code for the BMI. it does tell you to use an additional code to identify the type of obesity from the E66 code grouping. and of course under these codes they instruct you to add the BMI. But with the codign clinic instruction- I would not add BMI.

    Clinically BMI is based on weight and height to calculate and a pregnant woman will have higher weight but this not the same as a patient's true weight.
  • kruisegirlkruisegirl
    edited June 2020
    Laurie, 
    I have a question about this too and I'm not finding anything in a coding clinic for it. Mainly, I saw what you mentioned in your first post that we do not code the BMI's. That I knew. I recently bought a book for helping the CDI to code OB, which I was an RN in L&D for 30+ years before going to CDI. In this book it says what you do in your first post. I just wanted to verify that the information is still current? And is there a current coding clinic or something that I can use as a reference and share with our coders? 
    Thank you
    Debbie
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