ICD-10 Coding for Class 3 Obesity(E66.813)
Complete ICD-10-CM coding and documentation guide for Class 3 Obesity. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Class 3 Obesity
E66.8-E66.9Primary Range
Obesity codes including specific classes and other obesity
This range includes specific codes for different classes of obesity, including class 3.
Body Mass Index (BMI) codes for adults
These codes are used to specify the BMI range, which is essential for classifying obesity.
Key Information: ICD-10 code for class 3 obesity
Essential facts and insights about Class 3 Obesity
Primary ICD-10-CM Code for class 3 obesity
Decision Criteria
clinical Criteria
- BMI ≥40.0 documented by provider
documentation Criteria
- Explicit mention of 'class 3 obesity'
Applicable To
- Morbid obesity
Excludes
- Obesity hypoventilation syndrome (E66.2)
Clinical Validation Requirements
- BMI ≥40.0 documented by provider
- Explicit documentation of 'class 3 obesity'
Code-Specific Risks
- Using outdated codes like E66.01 when class 3 is documented
Coding Notes
- Ensure BMI is documented by the provider and linked to the obesity diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Class 3 Obesity to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E66.813.
Impact
Clinical: Lack of specificity can affect treatment plans., Regulatory: Non-compliance with coding guidelines., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Educate providers on the importance of specifying obesity class., Implement EHR prompts for class documentation.
Impact
Reimbursement: Incorrect coding can lead to reduced reimbursement., Compliance: Non-compliance with updated coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Code E66.813 instead.
Impact
High audit frequency for BMI codes without provider documentation.
Mitigation Strategy
Ensure BMI is documented by the provider in every encounter.
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 3 Obesity, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Class 3 Obesity
Use these documentation templates to ensure complete and accurate documentation for Class 3 Obesity. These templates include all required elements for proper coding and billing.
Progress Note for Obesity Management
Specialty: Internal MedicineRequired Elements
- Assessment of obesity class
- BMI documentation
- Linkage to comorbidities
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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