Wiki Cardiologist office

[toody5723]

Good morning,

im having a debate at work in icd 10 obesity codes (ex. E66.9) can be use a primary code for an office vist, with a specialist office cardiologist. Can someone please help.

 

[thomas7331]

Yes, an obesity diagnosis can, and should, be the primary code for an office visit if this is the "diagnosis, condition, problem, or other reason for encounter/visit shown in the medical record to be chiefly responsible for the services provided." Some payers do have coverage restrictions on treatment for obesity and may not pay for a patient to see a cardiologist for this problem alone, so I'm guessing that may be the reason that you are hearing this, but it is not a coding rule or guideline. If that is what the cardiologist documents as the reason the patient was seen, then that is what has to be coded as the primary diagnosis.

 

[TThivierge]

Obesity and Cardio Dx.

Good morning,

im having a debate at work in icd 10 obesity codes (ex. E66.9) can be use a primary code for an office vist, with a specialist office cardiologist. Can someone please help.

Hi There!
Yes you can have E66 block as first dx per if doc's notation matches but if you want it to get paid...I would put Morbid Obesity first dx or the patient's heart problem and dx Z71.3 if diet being watched too. Also with the dx. E66 block it should match the percentage of adipose (BMI percentage)from the patient's record. Also add Z68 block of dx when using E66 dx code. This is a coding situation when bill these 2 dx together. Also Medicare and most payers will not pay unless the patient BMI is over 30% , but that is if you use dx Z71.3 first dx. with proper CPT code.

I hope this helps you

Lady T