BMI Code Assignment

hasley89

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Looking for advice on BMI code assignment with conditions other than obesity. All of my research has indicated this is only assigned secondary to a principal diagnoses of obesity. Thanks in advance for any feedback!
 

jonique.dietzen

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The BMI codes can be used for any patient as an information only code, meaning that most insurances won't cover the cost of a visit if this is the first listed diagnosis or the only diagnosis for the visit. The patient does not need to be obese, the BMI codes can also indicate that the patient is underweight.

Per the CDC, the BMI adult codes are for use for persons 20 years of age or older (Z68.1- Z68.45). BMI pediatric codes are for use for persons 2-19 years of age (Z68.5). Different insurance companies will sometimes have different cut off ages for the pediatric vs adult BMI codes, so if you are seeing denials I suggest that you appeal with insurance per the CDC guidelines.

https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html

Jonique Dietzen, CPC
 
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