Morbid Obesity ICD-10-CM Codes

What ICD-10 Codes are Used for Morbid Obesity 

The International Classification of Diseases, 10th Revision (ICD-10) is a globally recognized diagnostic coding system developed by the World Health Organization (WHO). It collects and reports health statistics, assists in healthcare management, and provides a systematic way of defining and recording diseases. There are several relevant Morbid Obesity ICD Codes:

1. E66.01 - Morbid (severe) obesity due to excess calories 

This code signifies that the patient's extremely overweight is primarily attributable to excessive caloric intake. The diagnosis is typically based on the patient's dietary habits and physical activity levels.

2. E66.2 - Morbid (severe) obesity with alveolar hypoventilation 

This diagnosis pertains to patients suffering from severe obesity who exhibit signs of alveolar hypoventilation. Alveolar hypoventilation is a breathing disorder characterized by low oxygen and high carbon dioxide levels in the blood. This condition often results in shortness of breath and can lead to serious complications if left untreated.

3. E66.8 - Other obesity 

This code covers instances of obesity that do not align with other categorical definitions. Examples include obesity resulting from endocrine disorders or as a side effect of certain medications.

4. E66.9 - Obesity, unspecified 

This is a general code used when the specific cause or type of the patient's obesity is not specified. It is typically used when there is insufficient information to categorize obesity more specifically.

5. Z68.35 - Body Mass Index (BMI) 40-44.9, adult 

This diagnostic code applies to adult patients whose BMI falls within the range of 40-44.9. This range is considered a level of obesity according to WHO standards.

6. Z68.36 - Body Mass Index (BMI) 45.0-49.9, adult 

This code is used for adult patients with a BMI between 45.0 and 49.9. This range indicates severe obesity, significantly increasing the risk of obesity-related health issues.

7. Z68.37 - Body Mass Index (BMI) 50-59.9, adult 

This code pertains to adult patients with a BMI between 50 and 59.9. This range indicates morbid obesity, an extreme level of obesity that poses serious health risks.

8. Z68.38 - Body Mass Index (BMI) 60 or more, adult 

This code is used for adult patients with a BMI of 60 or above, a category known as super obesity. This extreme level of obesity often requires aggressive treatment and management strategies to mitigate associated health risks.

To further your understanding of these ICD-10 codes for morbid obesity, consider referring to this explainer video.

Which Morbid Obesity ICD codes are Billable

The billability of ICD-10 codes can vary based on the specifics of each medical case and the reimbursement policies of individual health insurance providers. However, generally speaking, the following commonly used codes for morbid obesity are typically considered billable:

1. E66.01 - Morbid (severe) obesity due to excess calories: Yes
2. E66.2 - Morbid (severe) obesity with alveolar hypoventilation: Yes
3. E66.8 - Other obesity: Yes
4. E66.9 - Obesity, unspecified: Yes
5. Z68.35 - Body Mass Index (BMI) 40-44.9, adult: Yes
6. Z68.36 - Body Mass Index (BMI) 45.0-49.9, adult: Yes
7. Z68.37 - Body Mass Index (BMI) 50-59.9, adult: Yes
8. Z68.38 - Body Mass Index (BMI) 60 or more, adult: Yes

It's crucial to note that while these codes are generally billable, they must be used by the documentation guidelines for each patient's specific condition. Additionally, the ultimate decision on what is considered billable rests with the payer, so verifying with the individual insurance provider is always important.

Clinical Information

Morbid obesity, or severe obesity, is a serious health condition characterized by excessive body fat. Here's some key clinical information:

• Morbid obesity is typically defined as having a Body Mass Index (BMI) of 40 or above or over 100 pounds over the recommended weight for one's height and body type.
• Common health risks associated with morbid obesity include heart disease, stroke, type 2 diabetes, high blood pressure, and certain types of cancer.
• The condition can also lead to other health issues like sleep apnea, osteoarthritis, gallstones, and mental health conditions such as depression and anxiety.
• Causes of morbid obesity can vary but often include a combination of genetic factors, unhealthy dietary habits, lack of physical activity, and certain medical conditions or medications.
• Diagnosing morbid obesity involves various assessments, including physical examination, calculation of BMI, and evaluation of the patient's medical history.
• Treatment options for morbid obesity often involve a multi-disciplinary approach, including dietary changes, increased physical activity, behavior modification, medication, and in some cases, bariatric surgery.
• Treatment selection depends on the severity of obesity, other health conditions, and the individual's willingness and ability to participate in weight loss plans.
• Regular follow-ups are crucial in managing morbid obesity to monitor the patient's progress and adjust treatment plans as necessary.

Remember, each patient is unique, and treatment should always be personalized to fit their specific needs and circumstances.

Synonyms Include

• Severe Obesity
• Extreme Obesity
• Clinically Severe Obesity
• Gross Obesity
• Massive Obesity