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v1.0.0
ICD-10 Guide
ICD-10 CodesE66.811

E66.811

Billable

Obesity, class 1

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

Code Description

ICD-10 E66.811 is a billable code used to indicate a diagnosis of obesity, class 1.

Key Diagnostic Point:

Obesity, class 1, is defined as a body mass index (BMI) ranging from 30.0 to 34.9 kg/m². This classification indicates a moderate level of obesity that can lead to various health complications if not managed appropriately. Individuals with class 1 obesity may experience increased risks for conditions such as type 2 diabetes, hypertension, dyslipidemia, and obstructive sleep apnea. The management of class 1 obesity often involves lifestyle modifications, including dietary changes, increased physical activity, and behavioral therapy. In some cases, pharmacotherapy or surgical interventions may be considered, particularly if the individual has obesity-related comorbidities. Accurate assessment of BMI is crucial, as it serves as a primary indicator for obesity classification. Regular monitoring and follow-up are essential to evaluate the effectiveness of weight management strategies and to prevent the progression to higher classes of obesity, which carry greater health risks.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in BMI calculations and classifications
  • Need for comprehensive documentation of comorbidities
  • Potential for misclassification with similar codes
  • Variations in treatment approaches across specialties

Audit Risk Factors

  • Inadequate documentation of BMI measurements
  • Failure to document obesity-related comorbidities
  • Incorrect coding of obesity class
  • Lack of follow-up documentation on weight management

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Document BMI, weight history, and any obesity-related comorbidities.

Common Clinical Scenarios

Routine check-ups, management of chronic diseases exacerbated by obesity.

Billing Considerations

Ensure regular updates on weight management strategies and patient compliance.

Endocrinology

Documentation Requirements

Detailed assessment of metabolic syndrome components and treatment plans.

Common Clinical Scenarios

Management of diabetes or thyroid disorders in obese patients.

Billing Considerations

Document any pharmacological interventions and their outcomes.

Coding Guidelines

Inclusion Criteria

Use E66.811 When
  • According to ICD
  • 10 guidelines, E66
  • 811 should be used when the patient's BMI is documented as 30
  • 0 to 34
  • 9 kg/m² and when there is a clinical indication of obesity
  • related health issues
  • It is important to ensure that the documentation supports the diagnosis and that the BMI is calculated accurately

Exclusion Criteria

Do NOT use E66.811 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99401CPT Code

Preventive medicine counseling

Clinical Scenario

Used during visits for weight management counseling.

Documentation Requirements

Document the time spent and topics covered during counseling.

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 obesity, enabling better tracking of obesity-related health issues and improving the quality of care through targeted interventions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obesity, enabling better tracking of obesity-related health issues and improving the quality of care through targeted interventions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obesity, enabling better tracking of obesity-related health issues and improving the quality of care through targeted interventions.

Resources

Clinical References

  • •
    CDC Obesity Facts

Coding & Billing References

  • •
    CDC Obesity Facts

Frequently Asked Questions

What is the significance of coding obesity class?

Coding obesity class is crucial for understanding the severity of the condition and its associated health risks. It guides treatment decisions and helps in the management of comorbidities.