Obesity ICD-10-CM Codes

What ICD-10 Codes are Used for Obesity 

The International Classification of Diseases, 10th Edition (ICD-10) is a global diagnostic tool for epidemiology, health management, and clinical purposes. It aids in identifying health trends and statistics and provides a universal language for information exchange. A range of Obesity ICD-10 codes are used to classify and document this condition in healthcare settings:

1. E66.0 - Obesity due to excess calories: This code indicates that a patient's obesity arises from consuming more calories than they burn through physical activity and normal body functions. It covers situations where the patient's dietary intake exceeds their energy expenditure, leading to weight gain and obesity.
2. E66.01 - Morbid (severe) obesity due to excess calories: This code is used when a patient has developed severe or morbid obesity, typically defined as having a Body Mass Index (BMI) of 40 or higher. The causative factor is excessive calorie intake. Morbid obesity often accompanies other serious health conditions like heart disease, diabetes, and certain types of cancer.
3. E66.1 - Drug-induced obesity: Certain medications can lead to weight gain as a side effect. When a patient's obesity is primarily linked to such drugs, this code is applied. It's important to note that the medication must be directly associated with the weight gain for this code to be used.
4. E66.2 - Morbid (severe) obesity with alveolar hypoventilation: This code is assigned when a patient's severe obesity is associated with alveolar hypoventilation, a respiratory disorder characterized by inadequate ventilation leading to increased carbon dioxide and decreased oxygen in the blood.
5. E66.8 - Other obesity: This code serves as a catch-all category for cases of obesity resulting from causes that don't fit into the other defined categories. Examples might include obesity linked to specific genetic disorders or rare metabolic conditions.
6. E66.9 - Obesity, unspecified: When a patient is obese, but the specific cause or type of obesity has not been identified or documented, this code is used. It allows healthcare providers to document the presence of obesity even when further details are unavailable.

Each code provides a precise clinical description of a patient's obesity, allowing for clear communication between healthcare providers, accurate documentation for medical records, and appropriate coding for insurance reimbursement. Refer to the official ICD-10 coding manual or trusted medical coding resources for more detailed guidance on using these codes. You may also find this explainer video helpful.

Which Obesity ICD codes are Billable

Billable codes justify admission to an acute care hospital when used as a principal diagnosis. Here's the billability of the commonly used obesity ICD codes:

1. E66.0 - Obesity due to excess calories: Yes, this is a billable code.
2. E66.01 - Morbid (severe) obesity due to excess calories: Yes, this is a billable code.
3. E66.1 - Drug-induced obesity: Yes, this is a billable code.
4. E66.2 - Morbid (severe) obesity with alveolar hypoventilation: Yes, this is a billable code.
5. E66.8 - Other obesity: Yes, this is a billable code.
6. E66.9 - Obesity, unspecified: Yes, this is a billable code.

It's important to note that while these codes are typically billable, the exact coverage and reimbursement can vary among insurance providers. Therefore, always checking with the specific insurer when determining coverage is essential.

Clinical Information

• Obesity is a medical condition characterized by the excessive accumulation and storage of fat in the body. It's typically measured using body mass index (BMI), where a BMI of 30 or above indicates obesity.
• Obesity is a global health issue affecting millions of people worldwide. It's more prevalent in developed countries but is also increasing in developing nations. The World Health Organization estimates that over 1.9 billion adults were overweight in 2016; of these, over 650 million were obese.
• Various factors can lead to obesity, including genetic predisposition, lack of physical activity, unhealthy diet, medical conditions like hypothyroidism and polycystic ovarian syndrome, and certain medications.
• Obesity increases the risk of various health conditions, including heart disease, high blood pressure, type 2 diabetes, certain cancers, sleep apnea, osteoarthritis, and mental health issues such as depression and anxiety.
• Obesity treatment usually involves lifestyle modifications, such as improving diet, increasing physical activity, and behavior changes. In some cases, medications or surgery may be recommended.
• Preventive measures include maintaining a healthy diet rich in fruits, vegetables, lean proteins, and whole grains; regular physical activity; and regular check-ups to monitor weight and potential health issues.
• With appropriate treatment and lifestyle changes, people with obesity can lose weight and reduce their risk of developing associated health conditions. However, maintaining weight loss over the long term can be challenging and often requires ongoing management strategies.

Synonyms Include

• Excessive Body Fat
• Adiposity
• Overweight Condition
• Corpulence
• Weight Problem