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

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.