Home Health ICD-9/ICD-10 Alert

Question: Which ICD-9 codes can we use to track issues with a patient's weight? What kind of documentation do we need in order to use a code for overweight or morbid obesity? Must the physician directly link the weight issue to the reason we're seeing the patient?

Washington Subscriber

Answer: If the patient's weight is pertinent to your care then you may code obesity. Code for overweight, obesity and other hyperalimentation with codes from category 278.

Code obesity with 278.00 (Obesity, unspecified). Obesity is defined as a body mass index (BMI) of 30 or more.

Remember: The instructions in 278 ask you to also identify the body mass index, if known. Use a code from V85.0-V85.54 to add these details. You can easily calculate the BMI if you know the patient's height and weight by using a Web site such as the National Institute of Health's BMI calculator at www.nhlbisupport.com/bmi/bmi-m.htm.

For example: A patient who is 5 feet 2 inches and weighs 237 lbs. has a BMI of 43.3 and therefore is morbidly obese. For this patient, you would list 278.01 (Morbid obesity) and V85.4 (Body mass index 40 or over, adult).

The Centers for Medicare & Medicaid Services (CMS) has indicated that obesity is a risk factor that applies heavily to several of the outcomes, but that doesn't mean you need to code obesity on every patient who is obese. That information is captured at M0290 (High risk factors).