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ICD-10 Guide
ICD-10 CodesE66.81

E66.81

Billable

Obesity class

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

Code Description

ICD-10 E66.81 is a billable code used to indicate a diagnosis of obesity class.

Key Diagnostic Point:

Obesity class refers to a classification of obesity based on Body Mass Index (BMI), which is a key indicator of body fat and overall health. The classification system categorizes obesity into different classes: Class I (BMI 30-34.9), Class II (BMI 35-39.9), and Class III (BMI 40 and above). E66.81 specifically denotes obesity class, which is crucial for determining the severity of obesity and guiding treatment options. Obesity is associated with numerous health complications, including type 2 diabetes, hypertension, cardiovascular diseases, and certain types of cancer. Accurate classification of obesity is essential for effective weight management strategies, which may include lifestyle modifications, pharmacotherapy, or surgical interventions. Clinicians must assess BMI regularly and document any related health issues to provide comprehensive care and appropriate coding. The management of obesity often requires a multidisciplinary approach, involving dietitians, psychologists, and exercise specialists, to address the complex nature of this condition and its impact on overall health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in BMI calculations and classifications.
  • Need for precise documentation of weight-related comorbidities.
  • Differentiation between obesity classes for treatment planning.
  • Potential for misclassification due to lack of updated patient data.

Audit Risk Factors

  • Inadequate documentation of BMI and obesity class.
  • Failure to document obesity-related comorbidities.
  • Incorrect coding of obesity class leading to potential denials.
  • Lack of follow-up documentation for weight management plans.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed documentation of BMI, comorbidities, and treatment plans.

Common Clinical Scenarios

Management of diabetes in obese patients, hormonal evaluations.

Billing Considerations

Consideration of metabolic syndrome and its implications for obesity classification.

Nutrition

Documentation Requirements

Comprehensive dietary assessments and weight management plans.

Common Clinical Scenarios

Nutritional counseling for weight loss, dietary interventions for obesity-related conditions.

Billing Considerations

Documentation of patient progress and adherence to dietary recommendations.

Coding Guidelines

Inclusion Criteria

Use E66.81 When
  • According to ICD
  • 10 coding guidelines, E66
  • 81 should be used when the specific obesity class is documented
  • It is important to include any related comorbidities to support the medical necessity of treatment

Exclusion Criteria

Do NOT use E66.81 When
  • Exclusion criteria include conditions that may mimic obesity or are unrelated to body weight

Related ICD-10 Codes

Related CPT Codes

97802CPT Code

Medical nutrition therapy, individual, face-to-face

Clinical Scenario

Used for patients with obesity seeking dietary counseling.

Documentation Requirements

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

Specialty Considerations

Endocrinologists and dietitians should collaborate for comprehensive care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obesity classes, improving the accuracy of health records and facilitating better management of obesity-related conditions. This specificity aids in treatment planning and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obesity classes, improving the accuracy of health records and facilitating better management of obesity-related conditions. This specificity aids in treatment planning and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    CDC Obesity Facts
  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    CDC Obesity Facts
  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of coding obesity class?

Coding obesity class is crucial for determining the severity of the condition, guiding treatment options, and ensuring appropriate reimbursement for services related to obesity management.

How is BMI calculated?

BMI is calculated by dividing a person's weight in kilograms by their height in meters squared (kg/m²). This measurement helps classify individuals into different obesity categories.