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Orthopedic Coding Alert

Reader Questions:

Obesity Differs From Morbid Obesity

Question: We performed several knee replacements on an obese patient, and the surgeon wants me to add a secondary ICD-9 code of "morbid obesity" to indicate to the insurer why this patient required additional knee surgery. But the surgeon said he does not actually classify her as "morbidly" obese. Which ICD-9 code should I use to indicate that the patient is obese but not morbidly obese?

North Carolina Subscriber
Answer: When patients do not meet the definition for morbid obesity, you should list 278.00 (Obesity, unspecified). If the patient meets the definition of severe or morbid obesity, you should instead assign 278.01 (Morbid obesity).
ICD-9 defines morbid obesity as "increased weight beyond limits of skeletal and physical requirements (125 percent or more over ideal body weight), as a result of excess fat in subcutaneous connective tissues."

Exception: When the patient's increased weight is due to a medical condition, such as adiposogenital dystrophy (253.8) or obesity of endocrine origin (259.9), you should report the underlying condition instead of morbid obesity.

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