ICD-10 Coding for Obesity(E66.811, E66.812, E66.813)
Complete ICD-10-CM coding and documentation guide for Obesity. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Obesity
E66.8-E66.9Primary Range
Obesity and other hyperalimentation
This range includes specific codes for different classes of obesity based on BMI.
Body mass index (BMI) 30 or greater
These codes are used to specify the BMI range associated with 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 |
|---|---|---|---|
| E66.811 | Obesity, class 1 | Use when the provider documents class 1 obesity with a BMI between 30.0 and 34.9. |
|
| E66.812 | Obesity, class 2 | Use when the provider documents class 2 obesity with a BMI between 35.0 and 39.9. |
|
| E66.813 | Obesity, class 3 | Use when the provider documents class 3 obesity with a BMI of 40.0 or greater. |
|
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 obesity
Essential facts and insights about Obesity
Primary ICD-10-CM Codes for obesity
Decision Criteria
clinical Criteria
- BMI between 30.0 and 34.9
Applicable To
- BMI 30.0-34.9
Excludes
- Overweight (E66.3)
Clinical Validation Requirements
- BMI between 30.0 and 34.9 documented by provider
Code-Specific Risks
- Ensure BMI is documented by the provider, not calculated by the coder.
Coding Notes
- Ensure the provider's documentation supports the use of class 1 obesity codes.
E66.812 - Obesity, class 2
Use when the provider documents class 2 obesity with a BMI between 35.0 and 39.9.
Applicable To
- BMI 35.0-39.9
Excludes
- Overweight (E66.3)
Clinical Validation Requirements
- BMI between 35.0 and 39.9 documented by provider
Coding Notes
Ensure the provider's documentation supports the use of class 2 obesity codes.
E66.813 - Obesity, class 3
Use when the provider documents class 3 obesity with a BMI of 40.0 or greater.
Applicable To
- BMI 40.0 or greater
Excludes
- Overweight (E66.3)
Clinical Validation Requirements
- BMI 40.0 or greater documented by provider
Coding Notes
Ensure the provider's documentation supports the use of class 3 obesity codes.
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 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E66.811.
Impact
Clinical: Inadequate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Educate providers on documentation standards., Implement EHR prompts for BMI entry.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate data collection and reporting.
Mitigation Strategy
Use class-specific codes (E66.811, E66.812, E66.813) based on documented BMI.
Impact
Failure to document BMI can lead to audit findings.
Mitigation Strategy
Ensure BMI is documented in every patient encounter involving obesity.
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, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Obesity
Use these documentation templates to ensure complete and accurate documentation for Obesity. These templates include all required elements for proper coding and billing.
Primary Care Obesity Management
Specialty: Family MedicineRequired Elements
- Patient's weight and height
- Calculated BMI
- Associated comorbidities
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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