Outpatient Clinical Documentation Integrity (OP CDI) is always evolving. Let’s test your knowledge.  On our LinkedIn page, we will have a series of questions so you can test your knowledge about OP CDI.

Play along on Harmony Healthcare’s LinkedIn page and then come back here to check your answers.

Question 1: A patient with HTN, HLD, CHF, and a history of CVA noted to have a BMI of 40.71 on the previous DOS last month. What is the HCC opportunity?

  1. Severe, morbid obesity
  2. Obesity
  3. BMI 40-40.5 and obesity
  4. Option 1 and 3

Explanation:

  • From Coding Clinic 2nd quarter, pg 9. Class 3 obesity: Assign code E66.01, Morbid (severe) obesity due to excess calories, for Class 3 obesity. Class 3 obesity is synonymous with morbid obesity, which is classified to code E66.01.
  • BMI must include a nutritional status diagnosis that addresses a form of malnutrition, overweight, obesity, or morbid obesity that is documented by an acceptable provider. (Per AHA Coding Clinic 4th quarter 2018)
  • Clinical support: Morbid Obesity: most recent BMI >= 40 or most recent BMI >= 35 and at least one weight related cormorbid condition, for example: Diabetes, HTN, heart disease, stroke, arthritis and obstructive sleep apnea, GERD, hyperlipidemia, gallbladder disease, hyperuricemia and gout
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