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ICD-10 Guide
ICD-10 CodesE66.2

E66.2

Billable

Morbid (severe) obesity with alveolar hypoventilation

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

Code Description

ICD-10 E66.2 is a billable code used to indicate a diagnosis of morbid (severe) obesity with alveolar hypoventilation.

Key Diagnostic Point:

Morbid obesity, defined as a body mass index (BMI) of 40 or greater, is a significant health concern that can lead to various complications, including alveolar hypoventilation. This condition occurs when the body cannot adequately ventilate the alveoli, leading to insufficient oxygenation and carbon dioxide retention. Patients with morbid obesity often experience respiratory issues due to excess weight, which can compress the thoracic cavity and impair lung function. Alveolar hypoventilation can result in hypoxemia, hypercapnia, and respiratory acidosis, necessitating careful monitoring and management. Treatment typically involves weight management strategies, including dietary changes, physical activity, and in some cases, surgical interventions such as bariatric surgery. Understanding the interplay between obesity and respiratory function is crucial for effective patient care and coding accuracy.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise BMI calculations and documentation of obesity severity.
  • Involves understanding the relationship between obesity and respiratory conditions.
  • May necessitate additional codes for related complications.
  • Documentation must clearly indicate the presence of alveolar hypoventilation.

Audit Risk Factors

  • Inadequate documentation of BMI and obesity severity.
  • Failure to document the presence of alveolar hypoventilation.
  • Misuse of related codes without clear clinical justification.
  • Lack of comprehensive treatment plans in the medical record.

Specialty Focus

Medical Specialties

Pulmonology

Documentation Requirements

Detailed respiratory assessments, including ABG results and pulmonary function tests.

Common Clinical Scenarios

Patients presenting with sleep apnea, chronic obstructive pulmonary disease (COPD), or respiratory distress related to obesity.

Billing Considerations

Ensure clear documentation of the relationship between obesity and respiratory conditions.

Endocrinology

Documentation Requirements

Comprehensive metabolic assessments, including glucose levels and endocrine evaluations.

Common Clinical Scenarios

Patients with obesity-related diabetes or metabolic syndrome.

Billing Considerations

Document any weight management interventions and their outcomes.

Coding Guidelines

Inclusion Criteria

Use E66.2 When
  • According to ICD
  • 10 guidelines, E66
  • 2 should be used when both morbid obesity and alveolar hypoventilation are documented
  • It is essential to ensure that the documentation supports the diagnosis and that any related conditions are also coded appropriately

Exclusion Criteria

Do NOT use E66.2 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

43775CPT Code

Bariatric surgery

Clinical Scenario

Used for patients with morbid obesity requiring surgical intervention.

Documentation Requirements

Preoperative assessments, BMI calculations, and justification for surgery.

Specialty Considerations

Ensure that all obesity-related comorbidities are documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obesity-related conditions, improving the accuracy of diagnoses and treatment plans. E66.2 provides a clear distinction for morbid obesity with respiratory complications, facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obesity-related conditions, improving the accuracy of diagnoses and treatment plans. E66.2 provides a clear distinction for morbid obesity with respiratory complications, facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obesity-related conditions, improving the accuracy of diagnoses and treatment plans. E66.2 provides a clear distinction for morbid obesity with respiratory complications, facilitating better patient management.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of documenting BMI in relation to E66.2?

Documenting BMI is crucial as it establishes the severity of obesity, which directly impacts the coding of E66.2. Accurate BMI calculations help differentiate between various obesity classifications and ensure appropriate treatment and reimbursement.