October 18, 2018
It’s important for patients to understand the severity of morbid obesity and for providers to code it properly. Morbid obesity is defined as 100 pounds over ideal body weight or having a body mass index (BMI) ≥ 40 Kg/m2 in adults.
If a patient has a BMI ≥ 35 in addition to one or more co-morbid conditions that can be linked to obesity, such as high blood pressure or diabetes, the patient is considered to have morbid obesity.
Accurate documentation will allow you to capture the condition on a claim providing a complete picture of the patient’s health status. Accurate diagnostic data on claims supports public health efforts and accurate provider payment.
Tips for Documentation
- BMI may be documented by a healthcare professional other than a physician.
- Documentation of BMI alone cannot be used to code or assume morbid obesity; a provider must document the medical condition of “morbid obesity” or “severe obesity” in the patient’s medical record for it be coded as such.
For more information about documenting and coding Morbid Obesity or other chronic and complex conditions, email ProviderClinicalConsulting@Premera.com.