Wiki BMI during pregnancy

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LauraNewYork

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Hello all -
The OB group at my center are extremely insistent about putting a BMI in the Assessment & Plan for each prenatal care visit. (I am well aware of the 2019 ICD-10-CM guidelines state BMI should not be used during pregnancy.) Is there any risk associated with leaving the BMI code on:
1) a global OB prenatal care only claim (59425/59426)?
2) an EM prenatal claim pre-global time period?

Thank you in advance for your input. I don't want to continue pursuing this issue unless there is an associated risk.
 
This is not my areas of expertise, but there is very little risk that I can see in the code being on the claim since this would not affect payment under any reimbursement methodology that I have ever encountered. It could, however, cause denials if payers are strict about adhering to coding rules. That said, it is not correct coding. It is also incorrect reporting of patient information, which could potentially cause incorrect evaluation of patient risk or morbidity. It is fine for the providers to include that information in the assessment if they think they need it, but that doesn't mean it has to go on the claim. Why put it on the claim knowing that it will cause the claim to be incorrectly coded even if there is no risk in doing so?
 
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Medical Director & Billing Manager input to BMI issue

My original choice was to simply leave the BMI off of the claim. Unfortunately, this issue escalated up to the Medical Staff Director who has directed that the BMI be put on the claim and the Billing Manager is going along with the demand. This whole crazy situation started with the Medical Staff Director requesting coding/documentation education for providers. I never expected BMI to be such a big issue!
 
This came up recently at our office. We had been putting it on, however, the 2019 guidelines have been updated and specifically say not to include during pregnancy.

Body mass index (BMI)
BMI codes should only be assigned when the
associated diagnosis (such as overweight or
obesity) meets the definition of a reportable
diagnosis (see Section III, Reporting Additional
Diagnoses). Do not assign BMI codes during
pregnancy. See Section I.B.14 for BMI
documentation by clinicians other than the
patient’s provider.
 
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