Sconroy
New
Hello Everyone, I have my AAPC CRC certification and in the course material for BMI and Morbid Obesity, it documents the following: "the diagnoses of morbid obesity is only coded when documented as such by the treating provider and never assumed. Without the documentation of morbid obesity, the coder can only assign the proper code for the annotated BMI reading when present." The 2017 ICD-10-CM guidelines states that the BMI reading should only be reported as a secondary code.
My interpretation from the CRC course material and experience in Medicare Risk Adjustment; if the BMI reading is documented it can be reported for risk adjustment. The physician must document morbid obesity to report the diagnosis. Both diagnoses are assigned HCC 22. My manager is following the ICD-10 guidelines and stating that the BMI cannot be reported without documentation supporting morbid obesity, because BMI is a secondary diagnosis. Doesn't this apply to billing and not Medicare Risk Adjustment?
I would greatly appreciate it if someone could clarify the reporting of BMI and morbid obesity for Medicare Risk Adjustment.
Thank you
Sharyn P-C, BS, MLT, CPC, CRC
My interpretation from the CRC course material and experience in Medicare Risk Adjustment; if the BMI reading is documented it can be reported for risk adjustment. The physician must document morbid obesity to report the diagnosis. Both diagnoses are assigned HCC 22. My manager is following the ICD-10 guidelines and stating that the BMI cannot be reported without documentation supporting morbid obesity, because BMI is a secondary diagnosis. Doesn't this apply to billing and not Medicare Risk Adjustment?
I would greatly appreciate it if someone could clarify the reporting of BMI and morbid obesity for Medicare Risk Adjustment.
Thank you
Sharyn P-C, BS, MLT, CPC, CRC