ICD-10 Coding for Body Mass Index 30-39.9(E66.01, E66.9)
Complete ICD-10-CM coding and documentation guide for Body Mass Index 30-39.9. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Body Mass Index 30-39.9
Body mass index (BMI) 30.0-39.9, adult
These codes are used to report BMI values between 30.0 and 39.9, which are secondary to a primary diagnosis of obesity.
E66.01Primary Range
Morbid (severe) obesity due to excess calories
This code is used for morbid obesity when BMI is ≥35 with comorbidities.
E66.9Primary Range
Obesity, unspecified
This code is used when obesity is documented without specification of morbid obesity.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E66.01 | Morbid (severe) obesity due to excess calories | Use when BMI is ≥35 and there are documented comorbidities. |
|
| E66.9 | Obesity, unspecified | Use when obesity is documented without further specification. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for BMI 30-39.9
Essential facts and insights about Body Mass Index 30-39.9
Primary ICD-10-CM Codes for body mass index 30-39.9
Decision Criteria
clinical Criteria
- BMI ≥35 with comorbidities
documentation Criteria
- Provider must document 'morbid obesity'
Applicable To
- Morbid obesity with BMI ≥35 and comorbidities
Excludes
- Obesity NOS (E66.9)
Clinical Validation Requirements
- BMI ≥35
- Presence of comorbidities such as hypertension or diabetes
- Provider documentation of 'morbid obesity'
Code-Specific Risks
- Incorrectly coding without provider's explicit documentation of morbid obesity
Coding Notes
- Ensure documentation supports morbid obesity with comorbidities.
E66.9 - Obesity, unspecified
Use when obesity is documented without further specification.
Applicable To
- General obesity without specification
Excludes
- Morbid obesity (E66.01)
Clinical Validation Requirements
- Provider documentation of 'obesity'
Coding Notes
Ensure obesity is documented by the provider.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Body Mass Index 30-39.9 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E66.01.
Impact
Clinical: Leads to incomplete clinical records., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure BMI is linked to a diagnosis of obesity., Educate providers on documentation standards.
Impact
Reimbursement: Incorrect coding may lead to denied claims or incorrect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure provider explicitly documents 'morbid obesity' and lists comorbidities.
Impact
Audits may focus on whether BMI is properly documented and linked to a diagnosis.
Mitigation Strategy
Ensure all BMI entries are accompanied by a relevant diagnosis.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Body Mass Index 30-39.9, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Body Mass Index 30-39.9
Use these documentation templates to ensure complete and accurate documentation for Body Mass Index 30-39.9. These templates include all required elements for proper coding and billing.
Obesity with comorbidities
Specialty: Internal MedicineRequired Elements
- BMI value
- Provider's diagnosis
- List of comorbidities
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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