Ob-Gyn Coding Alert

Question: What distinguishes "obesity" from "morbid obesity"?

Texas Subscriber

Answer: According to the United States National Institutes of Health (NIH), the term "morbid obesity" means 50 to 100-percent (or 100 pounds) above one's ideal body weight, which normally means a person with a body mass index (BMI) of 40 or greater. Obesity, on the other hand, refers to a patient who has a BMI of 30 to 39.9.

If the patient meets the definition of severe or morbid obesity, you should assign 278.01 (Morbid obesity). When obese patients do not meet the morbid obesity definition, you should instead list 278.00 (Obesity, unspecified).

Tip: If you are dealing with a pregnant patient, the primary diagnosis code will be 649.1X (Obesity complicating pregnancy, childbirth or the puerperium), followed by either 278.01 or 278.00.

Exception: When the patient's increased weight is due to a medical condition, such as adiposogenital dystrophy (253.8) or obesity of endocrine origin (259.9), you should report the underlying condition instead of morbid obesity.