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Thread: higher payment for obesity on surgical coding

  1. #1
    Join Date
    Apr 2007

    Default higher payment for obesity on surgical coding

    AAPC: Back to School
    My doctor wants us to code all surgeries and pregnancies for obese patients with secondary codes showing that the patient is obese. My understanding is that if the obesity complicates the surgery or the delivery it needs to be documented extensively in the op report and then billed with a 22 modifier for and possibly a letter from the MD for higher payment consideration. I don't think just adding an extra code for obesity will result in a higher reimbursement. Does anyone have any experience with this?

  2. #2


    If the obesity is making the procedure be more difficult to the extent that is not allowing to be carried out as it normally is should be documented reason and should add modifier 22 with the obesity diagnosis and the BMI accordingly.
    It is all in the documenation and the extent of the severity.

    L.Ivonne Garcia CPC

  3. #3
    Join Date
    Apr 2007
    NCF Gainesville


    OMG, I have a neurosurgeon who tries to do this everytime. Just because patient is obese. Technically if the patient is MORBIDILY obese then you can append 22 and get paid, but this has to be extesively documented as to why it made the surgery more difficult. He seriously tries to get a 22 on every surgery b/c of weight, which I do not code b/c rarely is there enough documentation..hello...red flag...audit me!!! Sometimes I wonder if he just doesn't realize that neurosurgery is a difficult surgery. Gotta love em though!
    Jeni Smith, CPC, CPMA

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