This is the American ICD-10-CM version of G35 - other international versions of ICD-10 G35 may differ.
The 2018 edition of ICD-10-CM G35 became effective on October 1, 2017. G35 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. In an inpatient setting, only the obesity BMI codes for 40-plus are considered CC conditions but note that E66.01 is does group to the hierarchical condition categories for risk-adjustment purposes.Įditor’s note: This article originally appeared in JustCoding. About the ICD-10 Code for Multiple Sclerosis.
This guidance is important since there are some situations where a patient can have severe or morbid obesity with a BMI of 35-39.9 due to co-existing comorbid conditions. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis.” The provider’s statement that the patient has a particular condition is sufficient. To me, this means that as long as the documentation clearly links the condition to BMI, it would be considered clinically relevant.įor patients with provider documentation identifying “morbid” obesity, the code E66.01 (morbid obesity due to excess calories) can be assigned even if the BMI is not greater than 40, per Coding Clinic. As noted in the 2019 ICD-10-CM Official Guidelines for Coding and Reporting, Section I.A.19, “The assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists.
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According to Coding Clinic, Fourth Quarter, 2018, the ICD-10-CM manual does not identify a list of conditions that can be considered associated with a BMI. I have been asked if there could be situations where another weight-related diagnosis, such as sleep apnea, diabetes, or hypertension, could make the use of a BMI code relevant. I know this can be an issue since the various types of reimbursement methodologies, such as risk adjustment, include the BMI codes, but these codes were always meant to be accompanied by a corresponding diagnosis code.Ĭoding Clinic, Fourth Quarter, 2018, specifically states that the provider must provide documentation of a clinical condition such as obesity or overweight to justify the reporting of a code for BMI. BMI codes need to be supported as medically relevant by an associated diagnosis that is considered a reportable diagnosis.Ĭoding professionals must remember that BMI codes were never intended to be used as standalone codes. Q: Can an ICD-10-CM body mass index (BMI) code be used as a standalone code? If not, what documentation should we look for to justify the use of a BMI code?Ī: The 2019 ICD-10-CM Official Guidelines for Coding and Reporting state you cannot use a BMI code (found in ICD-10-CM code category Z68.-) alone.
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