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Morbid Obesity ICD 10 Codes, BMI Rules & Guidelines

A professional women give instruciton about Morbid Obesity.

Accurate Morbid Obesity ICD 10 Codes ensure proper medical billing, compliance, and patient care.  Morbid Obesity ICD-10 Codes: E66.01, E66.9, E66.2 & BMI Guidelines

Understand the 2025 ICD-10-CM diagnosis code system for morbid obesity with precise body mass index (BMI) classifications. 

Use billable specific ICD-10-CM code E66.01 for diagnosis for reimbursement purposes and ensure proper documentation, especially effective on October 1, 2024, for updates to the American ICD-10-CM version. 

Know when to apply context annotation back references, annotation back references refer, and understand how references refer to codes in the international versions of ICD-10. Pediatric cases must consider BMI pediatric norms and percentiles for age, using the 95th percentile as a key threshold.

Primary ICD-10 Codes for Morbid Obesity

E66.9 – Obesity, Unspecified

  • Use Case: When BMI is undocumented or not calculated.
  • Limitations: Avoid if BMI or obesity class is known.

E66.01 – Morbid (Severe) Obesity Due to Excess Calories

  • Class 3 Obesity: BMI ≥40 (or ≥35 with comorbidities).
  • Key TermsMorbid severe obesity ICD-10super morbid obesity ICD-10.

E66.2 – Morbid Obesity with Alveolar Hypoventilation

  • Examples: Obesity hypoventilation syndrome (OHS).

E66.3 – Overweight

  • BMI 25-29.9Non-morbid obesity ICD-10.

BMI-Specific ICD-10 Codes for Obesity

Code

Description

BMI Range

E66.01

Class 3 (Morbid) Obesity

≥40

Z68.43

BMI 50-59.9 (Super Morbid Obesity)

50.0-59.9

E66.8

Other Obesity (Class 1/2)

30-39.9

Z68.41

BMI 35-39.9 (Class 2)

35.0-39.9

Z68.3

BMI 30-34.9 (Class 1)

30.0-34.9

 

Special Cases & Comorbidities

Psychological Factors (F55.8)

  • Use with E66.01 for psychological factors affecting morbid obesity ICD-10.

Maternal Morbid Obesity (O99.214)

  • For pregnancy-related coding.

Immunodeficiency Due to Obesity (D84.81)

  • Immunodeficiency due to morbid obesity ICD-10.

History of Morbid Obesity (Z86.39)

  • For resolved cases impacting current care.

ICD-10 Coding Guidelines for Morbid Obesity

  • Document BMI: Always link codes like E66.01 to a BMI ≥40 (e.g., Z68.45 for BMI 50+).
  • Avoid Unspecified Codes: Use E66.9 only when BMI/class is unknown.
  • Comorbidities First: List conditions like hypertension (I10) before obesity codes.
  • 2025 Updates: Confirm code revisions annually (e.g., morbid obesity ICD-10 2025).

Common Coding Mistakes to Avoid

  • Mixing Classes: Class 3 (E66.01) ≠ Class 2 (Z68.41).
  • Ignoring BMI: Unspecified codes (E66.9) risk claim denials.
  • Overlooking Comorbidities: Code OHS (E66.2) or psychological factors (F55.8) separately.

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Conclusion

ICD-10 code E66.01 for morbid weight problems is a critical tool for healthcare providers to diagnose and manage this extreme circumstance. By knowing what morbid weight problems are, the applicable ICD-10 codes, BMI prognosis codes, and the complications related to weight problems, carriers can make sure that sufferers acquire first-class feasible care. 

Proper coding and documentation are also crucial for correct repayment, making it vital for carriers to stay knowledgeable about state-of-the-art coding recommendations and payer rules.

Frequently Asked Questions (FAQs)

E66.01 (morbid obesity) + Z68.4x (specific BMI).

Use E66.01 + R93.89 (abdominal fat localization).

Yes, but payer-specific (morbid obesity ICD-10 billable codes).

Obesity is categorized into four primary types based on cause and distribution:

  • Exogenous obesity: Caused by overeating/sedentary lifestyle (most common).
  • Endogenous obesity: Linked to hormonal/metabolic disorders (e.g., hypothyroidism).
  • Visceral obesity: Fat stored around abdominal organs (high risk for heart disease).
  • Hyperplastic/hypertrophic obesity: Increased fat cell number (hyperplastic) or size (hypertrophic).

Based on BMI severity:

  • Class 1 (Mild): BMI 30.0–34.9.
  • Class 2 (Moderate): BMI 35.0–39.9.
  • Class 3 (Severe/Morbid): BMI ≥40.0.

Morbid obesity (Class 3) is defined as:

  • BMI ≥40.0, or
  • BMI ≥35.0 with obesity-related comorbidities (e.g., diabetes, hypertension).

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