ICD-10 Coding for Severe Obesity(E66.813, E66.01)
Complete ICD-10-CM coding and documentation guide for Severe Obesity. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Severe Obesity
E66.0-E66.9Primary Range
Obesity and other hyperalimentation
This range includes codes for various forms of obesity, including severe obesity and its complications.
Body mass index (BMI) 40.0-44.9, adult
These codes are used to specify the BMI of patients diagnosed with severe 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 |
|---|---|---|---|
| E66.813 | Class 3 obesity | Use when the provider documents 'Class 3 obesity' or 'BMI 40.0-44.9 with obesity-related complications'. |
|
| E66.01 | Morbid obesity due to excess calories | Use when 'morbid obesity due to excess calories' is documented. |
|
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 severe obesity
Essential facts and insights about Severe Obesity
Primary ICD-10-CM Codes for severe obesity
Decision Criteria
clinical Criteria
- BMI ≥40 with documented complications.
Applicable To
- Severe obesity with BMI ≥40
Excludes
- Obesity due to drugs (E66.1)
Clinical Validation Requirements
- BMI ≥40
- Presence of obesity-related complications
Code-Specific Risks
- Ensure documentation explicitly states 'Class 3 obesity'.
Coding Notes
- Ensure BMI and any comorbid conditions are documented.
E66.01 - Morbid obesity due to excess calories
Use when 'morbid obesity due to excess calories' is documented.
Applicable To
- Morbid obesity
Excludes
- Obesity due to drugs (E66.1)
Clinical Validation Requirements
- BMI ≥35 with comorbidities
Coding Notes
Ensure provider links BMI to 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 Severe 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: Inaccurate clinical records., Regulatory: Potential audit issues., Financial: Incorrect billing.
Mitigation Strategy
Use templates that prompt for BMI documentation., Educate providers on documentation standards.
Impact
Reimbursement: May lead to incorrect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Compromises data accuracy.
Mitigation Strategy
Ensure provider explicitly documents 'morbid obesity'.
Impact
Inadequate documentation of obesity class can lead to audit findings.
Mitigation Strategy
Ensure explicit documentation of 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 Severe Obesity, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Severe Obesity
Use these documentation templates to ensure complete and accurate documentation for Severe Obesity. These templates include all required elements for proper coding and billing.
Patient with severe obesity and comorbidities
Specialty: Internal MedicineRequired Elements
- BMI measurement
- Obesity class
- Comorbid conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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