HCC Coding for Providers – Morbid Obesity Guidelines

Per the CMS Participant Guide, “Physicians should document and code all conditions that co-exist at the time of the encounter/visit that require or affect patient care treatment or management.” 1

Morbid obesity (BMI of 40 or greater) is an example of a status condition that must be documented and coded at least every year. 

Note: To code this accurately, you must use E66.01 AND the specific BMI code: Z68.4X. (For morbid obesity with alveolar hypoventilation, use E66.2)

We have one final session of the HCC Coding for Providers CME program. If you were unable to attend any of the previous programs, please do not miss the opportunity to meet this Tier 1 incentive requirement: June 20 @ 5:30pm in the Mannix Conference Room (H&V Center)

Source:

  1. 2008 Risk Adjustment Data Technical Assistance For Medicare Advantage Organizations Participant Guide 6.4.1 Co-existing and Related Conditions.