E66.813

Billable

Obesity, class 3

HCC Category Mapping

V28HCC 48 — Morbid Obesity

0.226

V24HCC 22 — Morbid Obesity

0.250

ESRDHCC 22 — Morbid Obesity

0.000

What This Code Means

Class 3 obesity, the most severe level of obesity typically defined as BMI 40 or higher.

Coding Tips

•Class 3 obesity may also qualify as morbid obesity; review documentation for E66.01 applicability
•Document BMI ≥40 to support this classification

Clinical Significance

Obesity class 3 represents the most severe classification of obesity based on body mass index of 40 or higher. This classification system aligns with World Health Organization standards and carries the same clinical implications as morbid obesity, including dramatically elevated risks of cardiovascular disease, diabetes mellitus, musculoskeletal disorders, and premature mortality. This code provides an alternative to E66.01 for classifying severe obesity.

Documentation Requirements

✓Documentation must include a specific body mass index of 40 or higher with a Z68.4x code assigned additionally.
✓The provider should document the diagnosis of class 3 or severe obesity explicitly.
✓Associated comorbidities, current weight management strategies, and any referrals for bariatric evaluation should be documented.
✓The clinical impact of obesity on the patient's overall health status should be noted.

Commonly Confused Codes

E66.01 (Morbid obesity due to excess calories) is an overlapping code that should not be assigned simultaneously.E66.2 (Morbid obesity with alveolar hypoventilation) includes the respiratory component.E66.811 (Obesity, class 1) and E66.812 (Obesity, class 2) represent lower body mass index ranges.E66.09 (Other obesity due to excess calories) is for non-morbid obesity.Z68.4x codes are supplementary body mass index codes, not standalone diagnoses.

Code Hierarchy

└E66Overweight and obesity └E66.8Other obesity └E66.81Obesity class └E66.813Obesity, class 3

└E66.813Obesity, class 3