ICD-10 Coding for Class 1 Obesity(E66.811)
Complete ICD-10-CM coding and documentation guide for Class 1 Obesity. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Class 1 Obesity
E66.8-E66.9Primary Range
Other obesity and unspecified obesity
This range includes specific codes for different classes of obesity, including Class 1 Obesity.
Key Information: ICD-10 code for Class 1 Obesity
Essential facts and insights about Class 1 Obesity
Primary ICD-10-CM Code for class 1 obesity
Decision Criteria
clinical Criteria
- BMI documented between 30.0 and 34.9
documentation Criteria
- Explicit mention of 'Class 1 Obesity'
Applicable To
- BMI 30.0-34.9
Excludes
- Morbid obesity (E66.01)
Clinical Validation Requirements
- Provider-documented BMI between 30.0 and 34.9
- Explicit documentation of 'Class 1 Obesity'
Code-Specific Risks
- Incorrectly using E66.01 for BMI < 40 without comorbidities
Coding Notes
- Ensure provider documentation explicitly states 'Class 1 Obesity' or the specific BMI range.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
BMI 30.0-34.9
Z68.30-Z68.34Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Morbid (severe) obesity
E66.01Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Class 1 Obesity to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E66.811.
Impact
Clinical: May lead to under-treatment of obesity., Regulatory: Non-compliance with coding guidelines., Financial: Potential loss of reimbursement.
Mitigation Strategy
Educate providers on linking BMI to diagnosis, Use templates that prompt for class documentation
Impact
Reimbursement: May affect risk adjustment scores and reimbursement rates., Compliance: Could trigger audits for lack of specificity., Data Quality: Leads to inaccurate data on obesity prevalence.
Mitigation Strategy
Query provider for specific class or use E66.811 if Class 1 is confirmed.
Impact
Using unspecified codes when specific class codes are available.
Mitigation Strategy
Educate providers on documenting obesity class and BMI.
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 Class 1 Obesity, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Class 1 Obesity
Use these documentation templates to ensure complete and accurate documentation for Class 1 Obesity. These templates include all required elements for proper coding and billing.
Primary Care Visit
Specialty: Primary CareRequired Elements
- Patient's BMI
- Obesity class
- Related comorbidities
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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