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v1.0.0
ICD-10 Guide
ICD-10 CodesE66.812

E66.812

Billable

Obesity, class 2

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

Code Description

ICD-10 E66.812 is a billable code used to indicate a diagnosis of obesity, class 2.

Key Diagnostic Point:

Obesity, class 2, is defined as a body mass index (BMI) ranging from 35.0 to 39.9 kg/m². This classification indicates a significant level of excess body weight that can lead to various health complications. Individuals with class 2 obesity are at an increased risk for comorbid conditions such as type 2 diabetes, hypertension, dyslipidemia, and cardiovascular diseases. The pathophysiology of obesity involves a complex interplay of genetic, environmental, and behavioral factors that contribute to an imbalance between caloric intake and energy expenditure. Effective weight management strategies for individuals with class 2 obesity often include lifestyle modifications such as dietary changes, increased physical activity, and behavioral therapy. In some cases, pharmacotherapy or surgical interventions may be considered to achieve significant weight loss and improve overall health outcomes. Accurate coding of obesity is crucial for appropriate reimbursement and to ensure that patients receive the necessary care for their condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in BMI calculations and classifications
  • Need for precise documentation of comorbid conditions
  • Potential for misclassification with other obesity codes
  • Documentation of weight management strategies

Audit Risk Factors

  • Inadequate documentation of BMI measurements
  • Failure to document comorbid conditions
  • Misuse of obesity codes without proper clinical context
  • Lack of evidence for weight management interventions

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed documentation of BMI, comorbidities, and treatment plans.

Common Clinical Scenarios

Management of patients with obesity-related endocrine disorders.

Billing Considerations

Ensure accurate documentation of metabolic syndrome and related conditions.

Nutrition

Documentation Requirements

Comprehensive dietary assessments and weight management plans.

Common Clinical Scenarios

Counseling for dietary changes and lifestyle modifications.

Billing Considerations

Documenting patient progress and adherence to dietary recommendations.

Coding Guidelines

Inclusion Criteria

Use E66.812 When
  • Follow the official ICD
  • CM coding guidelines for obesity, ensuring accurate BMI calculations and documentation of any associated conditions
  • Include specific details about the patient's weight management plan

Exclusion Criteria

Do NOT use E66.812 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97802CPT Code

Medical nutrition therapy, individual, face-to-face

Clinical Scenario

Used for patients with class 2 obesity seeking dietary counseling.

Documentation Requirements

Document the patient's BMI, dietary history, and goals.

Specialty Considerations

Endocrinologists and dietitians should collaborate on treatment plans.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obesity, improving the ability to capture the severity and associated complications of the condition, which is crucial for appropriate reimbursement and care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obesity, improving the ability to capture the severity and associated complications of the condition, which is crucial for appropriate reimbursement and care management.

Reimbursement & Billing Impact

reimbursement and care management.

Resources

Clinical References

  • •
    Obesity Management: A Guide for Clinicians

Coding & Billing References

  • •
    Obesity Management: A Guide for Clinicians

Frequently Asked Questions

What is the BMI range for class 2 obesity?

Class 2 obesity is defined as a BMI ranging from 35.0 to 39.9 kg/m².

What are common complications associated with class 2 obesity?

Common complications include type 2 diabetes, hypertension, dyslipidemia, and increased risk of cardiovascular diseases.