Wiki Obesity class 2025 changes

[allyssa.kittle@va.gov]

When coding the obesity codes with the class 1 ,2, or 3 does the physician need to document the class or can the coder make that determination with the BMI?

 

[Cmama12]

When coding the obesity codes with the class 1 ,2, or 3 does the physician need to document the class or can the coder make that determination with the BMI?

The coder can't select a diagnosis based on BMI. The type of obesity must be documented

 

[MedCodingGirl]

If the provider documents Obesity due to excess calories, class 2, will we use 3 codes? E66.812, E66.09, and Z68...... ? Or will it just be the class E66.812 with the BMI Z68....?

 

[herbroom1]

If the provider documents Obesity due to excess calories, class 2, will we use 3 codes? E66.812, E66.09, and Z68...... ? Or will it just be the class E66.812 with the BMI Z68....?

Hello, Did you get a response on this question? We are have providers that document severe obesity due to excess calories and we are on the fence on which dx code to use.

 

[Cmama12]

This Q+ A tries to address some of these questions. Our Coding Clinic access is only currently through Q2, so I can't yet see what they say in Q4, but it sounds like further clarification is needed.

Q&A: New ‘Other obesity’ codes | ACDIS

 

[kdlberg]

If the wording is "Severe obesity due to excess calories," I would use E66.01. My reasoning is that it includes why the patient is obese. As an example of how this could be important: a payer may decide they will only pay for ozempic-like drugs for patients who consistently have severe obesity plus Z codes for diet and exercise counseling.