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v1.0.0
ICD-10 Guide
ICD-10 CodesE66.3

E66.3

Billable

Overweight

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 E66.3 is a billable code used to indicate a diagnosis of overweight.

Key Diagnostic Point:

Overweight is defined as having a body mass index (BMI) between 25 and 29.9. It is a significant public health concern as it can lead to various obesity-related complications, including cardiovascular diseases, type 2 diabetes, and certain cancers. The condition arises from an imbalance between calorie intake and energy expenditure, often influenced by genetic, environmental, and behavioral factors. Individuals classified as overweight may not exhibit immediate health issues, but they are at an increased risk for developing chronic conditions over time. Weight management strategies, including dietary modifications, physical activity, and behavioral interventions, are essential for reducing the risk of progression to obesity (BMI ≥ 30) and associated health complications. Accurate coding of overweight is crucial for appropriate treatment planning and reimbursement, as it reflects the patient's health status and potential need for intervention.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in BMI calculations and classifications.
  • Need for precise documentation of weight and height measurements.
  • Differentiation from obesity codes (E66.0-E66.9).
  • Potential for co-morbid conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of BMI and weight measurements.
  • Failure to document co-morbid conditions.
  • Misclassification of overweight as obesity.
  • Lack of evidence for weight management interventions.

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document BMI, weight history, and any related health conditions.

Common Clinical Scenarios

Routine check-ups, weight management consultations, and chronic disease management.

Billing Considerations

Ensure accurate BMI calculations and document lifestyle interventions.

Endocrinology

Documentation Requirements

Detailed assessment of metabolic syndrome and related endocrine disorders.

Common Clinical Scenarios

Management of diabetes, thyroid disorders, and hormonal imbalances.

Billing Considerations

Document any hormonal evaluations and treatment plans.

Coding Guidelines

Inclusion Criteria

Use E66.3 When
  • According to ICD
  • 10 guidelines, E66
  • 3 should be used when the patient's BMI is documented as overweight
  • It is essential to include the patient's height and weight in the medical record to support the diagnosis

Exclusion Criteria

Do NOT use E66.3 When
  • Exclusion criteria include conditions that may cause weight gain unrelated to lifestyle factors

Related ICD-10 Codes

Related CPT Codes

99401CPT Code

Preventive medicine counseling

Clinical Scenario

Used during weight management consultations.

Documentation Requirements

Document counseling provided and patient response.

Specialty Considerations

Primary care providers should ensure comprehensive lifestyle assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of overweight and obesity, improving the ability to track and manage these conditions. It has also emphasized the importance of accurate BMI documentation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of overweight and obesity, improving the ability to track and manage these conditions. It has also emphasized the importance of accurate BMI documentation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of overweight and obesity, improving the ability to track and manage these conditions. It has also emphasized the importance of accurate BMI documentation.

Resources

Clinical References

  • •
    CDC Obesity and Overweight

Coding & Billing References

  • •
    CDC Obesity and Overweight

Frequently Asked Questions

What is the difference between overweight and obesity?

Overweight is defined as having a BMI between 25 and 29.9, while obesity is classified as a BMI of 30 or higher. Both conditions increase the risk of health complications, but obesity is associated with a higher degree of risk.