ICD-10 Coding for Body Mass Index 35(E66.01, Z68.35)
Complete ICD-10-CM coding and documentation guide for Body Mass Index 35. 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 35
E66.0-E66.9Primary Range
Obesity
This range includes codes for different types of obesity, which are primary when coding BMI 35 with a documented obesity diagnosis.
Body Mass Index (BMI)
This range includes BMI codes, which are ancillary and used to provide additional detail to a primary obesity diagnosis.
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 is a documented diagnosis of morbid obesity with comorbidities. |
|
| Z68.35 | Body Mass Index (BMI) 35.0-35.9, adult | Use as a secondary code when a primary obesity diagnosis 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 BMI 35
Essential facts and insights about Body Mass Index 35
Primary ICD-10-CM Codes for body mass index 35
Decision Criteria
clinical Criteria
- BMI ≥35 with documented comorbidities
documentation Criteria
- Explicit provider documentation of morbid obesity
Applicable To
- Morbid obesity with BMI ≥35 with comorbidities
Excludes
- Obesity due to drugs (E66.1)
Clinical Validation Requirements
- BMI ≥35 documented by provider
- Presence of comorbidities like hypertension or diabetes
Code-Specific Risks
- Incorrectly coding without a documented diagnosis of obesity
Coding Notes
- Ensure the provider has documented both the BMI and the obesity diagnosis.
Z68.35 - Body Mass Index (BMI) 35.0-35.9, adult
Use as a secondary code when a primary obesity diagnosis is documented.
Applicable To
- BMI 35.0-35.9
Excludes
- BMI under 35
Clinical Validation Requirements
- BMI explicitly documented by provider
Coding Notes
Do not use as a primary code; it must accompany a primary obesity diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Body Mass Index (BMI) 35.0-35.9, adult
Z68.35Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Body Mass Index 35 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E66.01.
Impact
Clinical: May lead to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Require explicit provider documentation of obesity.
Impact
Reimbursement: May lead to denied claims if BMI is coded without a primary diagnosis., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate health records and data reporting.
Mitigation Strategy
Ensure the provider has documented an obesity diagnosis before coding BMI.
Impact
Risk of audit if BMI is coded without a documented obesity diagnosis.
Mitigation Strategy
Ensure all BMI codes are supported by a primary obesity 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 35, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Body Mass Index 35
Use these documentation templates to ensure complete and accurate documentation for Body Mass Index 35. These templates include all required elements for proper coding and billing.
Morbid Obesity with Comorbidities
Specialty: Internal MedicineRequired Elements
- BMI explicitly documented
- Obesity diagnosis
- Comorbidities listed
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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