ICD-10 Coding for Obesity Class 1(E66.811)
Complete ICD-10-CM coding and documentation guide for Obesity Class 1. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Obesity Class 1
E66.8-E66.9Primary Range
Other obesity
This range includes specific codes for different classes of obesity, including class 1.
Body mass index (BMI) 30.0-39.9, adult
These codes are used as secondary codes to specify the BMI range for obesity.
Key Information: ICD-10 code for obesity class 1
Essential facts and insights about Obesity Class 1
Primary ICD-10-CM Code for obesity class 1
Decision Criteria
clinical Criteria
- BMI documented between 30.0 and 34.9
documentation Criteria
- Explicit mention of 'Class 1 obesity' in medical records
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
- Coding based solely on BMI without provider documentation.
Coding Notes
- Ensure provider documentation explicitly states 'Class 1 obesity' to use this code.
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 Obesity Class 1 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E66.811.
Impact
Clinical: Lack of specificity in patient care plans., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Train providers to document obesity class., Implement EHR prompts for obesity classification.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Ensure the provider explicitly documents 'Class 1 obesity'.
Impact
Coding obesity without specifying class can lead to audit issues.
Mitigation Strategy
Ensure provider documentation includes obesity class.
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 Obesity Class 1, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Obesity Class 1
Use these documentation templates to ensure complete and accurate documentation for Obesity Class 1. These templates include all required elements for proper coding and billing.
Routine visit for weight management
Specialty: Primary CareRequired Elements
- Explicit mention of 'Class 1 obesity'
- Documented BMI value and date
- Impact on comorbid conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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