What insurance is this for? And are you using 278.00 or 278.01? Medicare will not pay for either as a primary code--they require a complication/co-morbidity as the PDX (such as HTN, DJD, Hyperlipidemia).
If you look in the Tabular List of your ICD-9, you'll see 278.00 is "grayed out" which means unacceptable PDX. Try being more specific--278.01 or 278.02 depending on BMI.
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