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But
most doctors don't list body mass index on patient's charts
If you're
having trouble justifying gastric-bypass or other bariatric
surgery to carriers, then the new weight-related diagnosis
codes could be just what you need.
Starting Oct. 1, the ICD-9 diagnosis code set will include
a code for "overweight" (278.02) and 18 new codes
for assigning adult body mass index (BMI). "Those will
be very helpful," says Lisa Frye, coder with Hickory,
NC-based Hickory Surgical Clinic in Hickory, which performs
bariatric surgeries.
Not
only will the new codes be helpful in providing the patient's
BMI to payers when justifying bariatric surgeries, but they'll
also provide tremendous help in justifying the initial consult,
says Frye.
Right
now, noting a patient's BMI on the claim form is a lot harder,
says Mary Lou Walen, coding expert with the Bariatric Surgery
Association. "That is great news," she says about
the new codes. She assumes coders now normally list 278.1
(Morbid obesity) on the claim, followed by the appropriate
V-code for BMI.
Not
so fast: But don't expect doctors to start putting the
patient's BMI on the chart, warns coder Cathy Satkus with
Harvard Family Physicians in Tulsa, OK. Even when the doctor
notes the patient's body mass, he or she usually won't mark
it on the superbill. Doctors won't start noting this information
unless payers start requiring it for more conditions, Satkus
predicts.
Including
the patient's BMI on claims for surgical procedures where
where obesity is a factor might be a good idea, notes Anne
Karl, coder with St. Paul Heart Clinic in St. Paul, MN.
Obesity isn't a factor for every surgical patient, but it
might be worth noting if the surgeon feels it's a complicating
factor.
"I
can't see us educating the physicians ... to give us the
BMI when it's a factor," admits Karl, "because
it's not a key indicator." But her practice has incentive
programs with some payers built around programs like smoking
cessation or lifestyle management, and BMI might be a useful
factor for identifying target patients.
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