I’ve noted a few trends recently when educating medical professionals on coding guidelines for weight disorders. Many push back on the instructions to pair a weight disorder with a BMI, primarily in the name of provider-patient relationship. This pairing is essential for accurate quality scores and reimbursement, yet it can be seen as a sensitive topic in the provider-patient dynamic.
The debate around the use of Body Mass Index (BMI) and E66 codes in medical practice highlights the complexity of addressing weight-related health issues. While BMI is a widely used tool for assessing body weight, it is not without its limitations and does not account for muscle mass, bone density, overall body composition, and racial and sex differences. Medical professionals advocate for a more holistic approach that considers the multifaceted nature of health and avoids stigmatization. The focus is on creating a supportive environment that encourages healthy behaviors without casting judgment, recognizing that health is a personal journey unique to everyone.
One observed provider practice is to embrace BMIs, but shun any E66 codes that represent underweight, overweight, and obesity disorders. Providers feel that the label of “Obesity due to excess calories” reeks of judgement, rather than acceptance. BMIs are simply a measurement, they say, and we can work together on those measurements without unkind (and often unproductive) judgement.
Others do not embrace BMI codes, as they don’t necessarily consider the variables that might make an elevated BMI more reasonable for one patient than another. If the patient’s presentation warrants a weight disorder diagnosis, these providers feel more comfortable speaking to the patient about the risks of weight disorders rather than the statistic represented by the BMI.
ICD-10-CM is launching three new codes for Obesity Class 1, Class 2, and Class 3, effective October 1st, 2024. Will these codes change the game? Will providers feel more comfortable assigning a “label” if that label is less judgmental in its verbiage? It’s possible, but there are some challenges ahead to embrace the new codes. For example, some EMRs already use Obesity class 2 or Obesity class 3 as descriptions for E66.01 Morbid obesity due to excess calories. In some cases, we find descriptions that inaccurately say “Class 2 Severe Obesity.” Note that Class 3 is considered severe obesity, not class 2.
What steps can you take to ensure your clinicians have the necessary tools to approach reporting of weight disorders accurately?
- Educate – Clinicians must be informed about the latest coding options and their correct application. This can be achieved through regular training sessions and updates.
- Verify – A thorough review of current Electronic Medical Records (EMR) for accuracy and the implementation of a monitoring system for new codes can help maintain high standards and provide your clinicians with the best opportunity for success.
- Create Policies – Work with leadership to create coding policies that consider HIPAA mandated guidelines as well as patient-provider relationships. These efforts will provide a structured framework for clinicians to follow.
- Be Kind – Kindness and empathy should be at the core of all interactions. While adherence to coding guidelines is essential, the ultimate goal is to enhance patient care and outcomes. Policies and practices should be patient-centric, promoting a supportive environment that encourages accurate reporting without compromising the patient-provider relationship.
Overall, while the new ICD-10-CM codes for obesity have the potential to enhance clinical communication and patient care, the healthcare community must navigate the initial challenges to fully embrace the benefits of this updated classification system.
If you’d like to know more about these and other upcoming ICD-10-CM Coding Updates, join us for our live webinar on September 19th. Follow the link below to register now!