07/11/2025
📢 Coding Update: Obesity Coding Clarified – 1st Quarter 2025 Coding Clinic
Hi Members,
I hope you're all enjoying your summer so far! ☀️
The 2025 Q1 Coding Clinic has provided a helpful clarification regarding obesity coding, especially when it comes to documented obesity classes.
🔎 Key Clarification:
When a provider documents a specific class of obesity (e.g., Class 3 obesity), you should assign the code for that class (e.g., E66.813). In these cases, you should NOT assign the general obesity code E66.01 (Morbid obesity due to excess calories).
📌 Use this principle for all obesity classes (Class 1, 2, or 3) when the class is clearly documented. The specific obesity class code takes priority over the general codes.
✅ BMI Coding Reminder:
• BMI codes (Z68.-) should still be assigned in addition to the obesity code.
• BMI documentation can come from any clinician involved in patient care (e.g., dietitian, nurse), but the obesity diagnosis itself must be documented by the physician or other qualified healthcare provider.
⚠️ BMI Fluctuation Guidance:
• If the BMI fluctuates during the stay due to a clinically significant condition (like malnutrition or anorexia nervosa), code the most severe BMI value recorded.
• However, BMI changes from fluid overload or retention should NOT be coded, as these are not true indicators of the patient’s nutritional status.
🩺 Bonus Tip – Pickwickian Syndrome (E66.2):
Code E66.2 is used for morbid obesity with alveolar hypoventilation, also known as Pickwickian syndrome. It’s a sleep-related breathing disorder often associated with severe obesity or neurologic dysfunction.
