PDPM Coding Question – Can we code morbid obesity for resident with Dx on DC Summary but BMI is not 40 or above?

A:

You can assign the E66 morbid obesity code if it is specifically documented by the provider & some sort of intervention/treatment due to obesity (i.e. reduced calorie diet or weight reduction plan). If there is documentation of overweight or obesity by provider & BMI is >40, then you can code the Z code for BMI >40 and receive 1 NTA point without having specific MD documentation of “morbid” obesity.