Wiki clinical validation by provider

[siddharthaqa@rediffmail.com]

One of our providers informs us, “morbid obesity (E66.01) can be used with a BMI of greater than or equal to 35.0 with at least one obesity-related condition. Therefore, any patient with hypertension or diabetes and a BMI of 35.0 or greater can be coded as Morbid Obesity with the appropriate BMI code and other diagnoses.”

But according to my understanding, coders are not clinicians and clinical validation must be performed by a clinician. Therefore, a coder cannot code E66.01 (morbid obesity) unless it is documented in the report by a licensed clinician.

If anyone can provide me with some good reference to validate my understanding from an authentic source so that I can forward it to our provider that coder cannot code E66.01 (morbid obesity) if BMI is less than 40 (BMI of greater than or equal to 35.0 with at least one obesity-related condition, diabetes or hypertension)

Thank you in advance.

 

[thomas7331]

I responded to your post under diagnosis coding - please don't make multiple duplicate posts of the same questions as it's against the forum rules.

 

[siddharthaqa@rediffmail.com]

Okay, I was not sure if I have put the query under the correct segment. I will remember. Thank you