ICD-10 E66.01: Morbid (severe) obesity due to excess calories
BMI ≥40, or BMI ≥35 with comorbidities. Most accurate code for severe obesity warranting GLP-1 / bariatric surgery coverage.
Clinical context
BMI ≥40, or BMI ≥35 with comorbidities. Most accurate code for severe obesity warranting GLP-1 / bariatric surgery coverage.
Documentation requirements
- BMI ≥40 calculated and documented
- Z68.4x BMI code paired
- Comorbidity documentation if BMI 35-39.9 (HTN, T2DM, OSA, NAFLD)
Common related procedures
- 43644 bariatric surgery
- G0271 MNT for severe obesity
- 99214
Common payer denial patterns
- GLP-1 prior auth — even with E66.01, payers may require 6-month documented lifestyle attempt
Frequently asked questions
What does ICD-10 E66.01 mean?
Morbid (severe) obesity due to excess calories
When is this code documented?
BMI ≥40, or BMI ≥35 with comorbidities. Most accurate code for severe obesity warranting GLP-1 / bariatric surgery coverage.
What documentation supports this code?
BMI ≥40 calculated and documented; Z68.4x BMI code paired; Comorbidity documentation if BMI 35-39.9 (HTN, T2DM, OSA, NAFLD).
What are common denials associated with this diagnosis?
GLP-1 prior auth — even with E66.01, payers may require 6-month documented lifestyle attempt.
Related diagnoses
Sources
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