Coding, Classification and Reimbursement

Pediatric BMI stand alone code

  • 1.  Pediatric BMI stand alone code

    Posted 27 days ago
    Hi!

    As per ICD 10 guidelines, BMI code should only be assigned when there is a associated diagnosis(such as overweight, underweight or obesity). It can be documented in the notes but unless there is associated diagnosis, you would not code it.

    What if its pediatric exam, our doctors always report BMI and code it. Even when there is no diagnosis associated with it. Such as an annual exam, doctors always list BMI as a diagnosis because they are calculating it and assessing it.
    Can BMI be coded without a diagnosis in these cases?

    Thank you



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    Kathleen Cariello

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  • 2.  RE: Pediatric BMI stand alone code

    Posted 27 days ago

    Hi ~
    The coding guidelines would still apply even in a pediatric setting, as there is no age limit identified in the guidelines. A valid diagnosis is needed in order to report the BMI code.



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    Lynn A. Wall, MBA, RHIT, CCS
    Interim Coding Supervisor
    Maricopa Integrated Health System
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  • 3.  RE: Pediatric BMI stand alone code

    Posted 27 days ago
    Hi!

    Even if this an annual pediatric exam(Z00.129) where they always calculate and report BMI for growth?

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    Kathleen Cariello
    Internal Audit
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  • 4.  RE: Pediatric BMI stand alone code

    Posted 27 days ago
    ​As I recall, that is part and parcel of the annual exam/physical (height, weight, etc.) and not something separately billable for.   The calculation of BMI in and of itself does not warrant an additional code because it's just that, a calculation - nothing more, nothing less. When you state that the provider is assessing it - what exactly does that mean?

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    Lynn A. Wall, MBA, RHIT, CCS
    Interim Coding Supervisor
    Maricopa Integrated Health System
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  • 5.  RE: Pediatric BMI stand alone code

    Posted 27 days ago


    By assessing, I mean, Does this patient BMI within what the age and height?

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    Kathleen Cariello
    Internal Audit
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  • 6.  RE: Pediatric BMI stand alone code

    Posted 27 days ago
    ​Hi Kathleen - I would not consider that an assessment, but rather part of the annual exam process. I would not consider that a separately billable process warranting the BMI code assignment.  I would recommend sticking with the ICD-10-CM coding guideline as noted, however, I am curious as to what others think.  Thanks ~

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    Lynn A. Wall, MBA, RHIT, CCS
    Interim Coding Supervisor
    Maricopa Integrated Health System
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  • 7.  RE: Pediatric BMI stand alone code

    Posted 27 days ago
    Thats pretty much my thinking. Our doctors always code BMI even if there is no diagnosis associated with it. I just wanted to see what others thought.
    Thank you for taking the time to reply. I appreciate your input

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    Kathleen Cariello
    Internal Audit
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  • 8.  RE: Pediatric BMI stand alone code

    Posted 15 days ago
    I work at a FQHC and they have a BMI on just about every patient as usually the third or fourth diagnosis code. I think its more for when you have the BMI as the primary diagnosis code than it should be one of those health problems. Adding the BMI on each encounter probably helps identify a pattern, such as its always higher in the winter.

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    Steve Oehmen
    Outpatient Coder & Biller
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  • 9.  RE: Pediatric BMI stand alone code

    Posted 14 days ago
    Agree with those before me who recommended that a diagnosis is necessary to report the BMI.   Per CC 4th quarter 2018 pg 81-82, "...BMI codes are not intended for routine capture of BMI unless there is provider documentation of an associated diagnosis..."

    Hope that helps!

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    Jonathan MacKenzie
    Coding Compliance Auditor
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