Obesity Classification Coding Update: Navigating the New FY 2025 ICD 10 Codes for Obesity

Obesity Classification Coding Update: Navigating the New FY 2025 ICD 10 Codes for Obesity

The Fiscal Year 2025 ICD-10-CM updates have introduced significant changes to obesity classification codes, sparking industry-wide discussions following the Fourth Quarter 2024 Coding Clinic publication. These new codes ICD 10 codes for obesity represent a more granular approach to documenting the condition, but their implementation has raised important questions for medical coders nationwide.

Key Question: Can We Code Obesity Class Based on BMI Alone?

Short Answer: No.

Despite the detailed BMI ranges provided in the Coding Clinic, our current interpretation is that obesity class codes cannot be assigned based on BMI alone without explicit provider documentation of the specific obesity class.

The New Obesity Code Landscape

With the FY 2025 update, we now have four distinct obesity codes:

1. Obesity, unspecified (E66.9)
2. Obesity, class I (E66.01)
3. Obesity, class II (E66.02)
4. Obesity, class III (E66.03)

Notably, the BMI classification is not part of the code definition and is not an inclusive term.

Important Disclaimer: Our Current Perspective

Critical Context: The guidance provided here represents our current internal interpretation and is not definitive. We are actively seeking formal clarification from the Coding Clinic to validate our approach.

Our Preliminary Interpretation

Based on our thorough review of the Fourth Quarter 2024 Coding Clinic:

• We believe obesity class codes should only be used when specifically documented by the provider.
• BMI ranges discussed in the Coding Clinic are informative, not definitive coding criteria.
• When no specific class is documented, default to unspecified obesity code (E66.9).

Recommended Approach (Pending Confirmation from Coding Clinic)

1. Provider-documented obesity class: Use the corresponding specific code.
2. No specific class documented: Use unspecified obesity (E66.9).
3. Do NOT use BMI alone to determine obesity class.

Further Guidance to Come on New ICD 10 Codes for Obesity

We have reached out to the Coding Clinic to seek definitive clarification on the application of these new obesity class codes. Our current guidance is preliminary and subject to change based on their official interpretation. Stay tuned to the YES Blog for further updates.