Wiki Obesity, BMI and Weight Loss Medication

[vfernandez]

Good Morning
Obesity as I understand it, is a disease. Patients are obese with high BMI when they start the weight loss medication and improve over time. Should their initial diagnosis of obesity continue to be reported even as they lose weight on the medication as obesity is a chronic condition and without the medication, the patient will gain weight. This would be similar to a person with hypertension who takes medication and has controlled blood pressure but hypertension is reported as a chronic problem . Similarly a diabetic patient on multiple drugs may have their glucose under control but diabetes is still reported as an ongoing condition. Any formal guidance would be greatly appreciated Many thanks

 

[TThivierge]

Good Morning
Obesity as I understand it, is a disease. Patients are obese with high BMI when they start the weight loss medication and improve over time. Should their initial diagnosis of obesity continue to be reported even as they lose weight on the medication as obesity is a chronic condition and without the medication, the patient will gain weight. This would be similar to a person with hypertension who takes medication and has controlled blood pressure but hypertension is reported as a chronic problem . Similarly a diabetic patient on multiple drugs may have their glucose under control but diabetes is still reported as an ongoing condition. Any formal guidance would be greatly appreciated Many thanks

HiVfernandez
I d follow the documentation listed per provider.....if E66 Obesity dx block is listed add it. Do not assume. But remember if E66 dx is used add the BMI % if listed in medical documentation for the day. If obesity is the chronic problem and being treated for this , hopefully the provider is listing it down. After lose the obesity flab...no longer a current chronic problem. Follow the expert(provider s lead with his or her documentation). If pt is DM dx E11 or N18 or whatever used as chronic condition add it too if documented on the treatment day thus mentioned by provider.
I hope I helped you
Lady T

 

[Gator]

Good Morning
Obesity as I understand it, is a disease. Patients are obese with high BMI when they start the weight loss medication and improve over time. Should their initial diagnosis of obesity continue to be reported even as they lose weight on the medication as obesity is a chronic condition and without the medication, the patient will gain weight. This would be similar to a person with hypertension who takes medication and has controlled blood pressure but hypertension is reported as a chronic problem . Similarly a diabetic patient on multiple drugs may have their glucose under control but diabetes is still reported as an ongoing condition. Any formal guidance would be greatly appreciated Many thanks

We have the same question & thoughts regarding your comparison to HTN or DM. I read somewhere, and now I can't remember where, that we SHOULD carry thru their starting weight and BMI as well as starting date if being followed for weight management.
This I would think could help with leveling. Especially when the patient falls into the overweight category since overweight is not considered a chronic disease. However, the guidelines state that a stable, chronic illness is a problem w/duration of 1 year. The definition of problem is a disease, condition, illness, injury, symptom, finding, complaint .... So overweight WOULD still fall into chronic condition based upon these definitions. For example, patient with an 18 month documented history of obesity now overweight BMI range (stable chronic), parent is historian (1data) or Rx is involved this would level to a 3.
My question is when the BMI falls below overweight of 25. Since they are now neither overweight or obese, a "cosmetic' or "call mom" problem so to speak, is this now a minimal straight forward level 2 complexity of problem? Then even with medication management for maintenance of weight if no comorbidities, labs etc the overall level would still be a 2.
I know billers/coders can't interpret if BMI is no longer overweight if overweight is what the provider diagnoses. its more of a medical necessity standpoint as that is a consideration as well as the level of visit. If a patient comes in monthly at some point I feel like this is a simple straightforward weight check & how ya doin'?