We are looking for something definitive on when Morbid Obesity can be documented with a BMI of 35-39 but has DM, CAD, Sleep Apnea, Hypertension, etc... We are looking for a clear and definitive guideline for the PHYSICIAN that they are to follow and when it is acceptable to use BMI of 35-39 and diagnose Morbid Obesity. Does anyone no where I can find that guideline. Again, I am looking for the guideline for the Physician, no the coding guideline. I have looked through all the sites and find a lot of general info, but nothing that states what the physicians guidelines are for coding Morbid Obesity.
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Wiki Morbit Obesity
- Thread starter tfunk504
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SDAlward
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I'm sorry I can't remember where I read this, but if a patient has a comorbid condition caused by the obesity, or the obesity puts the patient's health at risk, it can be coded as morbid if their BMI is 35-39. I would just make sure the physician documents a relationship between the patient's health factors and the obesity. (ex, a patient has HTN and their BMI is 36, they could be considered morbidly obese if the HTN is due to the obesity, and weight loss would have an impact of reducing their blood pressure) Hope that makes sense 
Cynthia Hughes
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Per the ICD-10 guidelines, the physician must document a diagnosis of obesity. "For the Body Mass Index (BMI), depth of non-pressure chronic ulcers and pressure ulcer stage codes, code assignment may be based on medical record documentation from clinicians who are not the patient’s provider (i.e., physician or other qualified healthcare practitioner legally accountable for establishing the patient’s diagnosis), since this information is typically documented by other clinicians involved in the care of the patient (e.g., a dietitian often documents the BMI and nurses often documents the pressure ulcer stages). However, the associated diagnosis (such as overweight, obesity, or pressure ulcer) must be documented by the patient’s provider. If there is conflicting medical record documentation, either from the same clinician or different clinicians, the patient’s attending provider should be queried for clarification."