Z68.45

Billable

Body mass index [BMI] 70 or greater, adult

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

A measurement of body weight relative to height (BMI) of 70 or greater in adults, indicating severe obesity.

Coding Tips

•BMI codes are status codes used for documentation purposes and should be reported alongside the diagnosis of obesity (E66.x) when applicable
•Ensure the BMI calculation is documented in the medical record; these codes require actual BMI values, not estimates

Clinical Significance

This code indicates the most severe level of obesity with BMI 70 or greater, representing extreme health risk requiring immediate intensive medical management and urgent surgical intervention. Super-morbid obesity at this level is associated with dramatically increased mortality and requires specialized tertiary care management.

Documentation Requirements

✓Documented BMI calculation of 70 or greater
✓Patient age confirmed as adult (18+ years)
✓Height and weight measurements supporting BMI calculation
✓Comprehensive assessment of obesity-related complications
✓Provider documentation of super-morbid obesity
✓Multiple serious comorbidities typically documented
✓Urgent multidisciplinary treatment plan including immediate surgical evaluation
✓Specialized bariatric center referrals

Commonly Confused Codes

Z68.44 — Use when BMI is 60.0-69.9 instead of 70+Z68.43 — Use when BMI is 50.0-59.9 instead of 70+E66.01 — Use for morbid obesity due to excess calories, not BMI code alone Z68.54 — Use for pediatric BMI >95th percentile, not adult BMI Z68.42 — Use when BMI is 45.0-49.9 instead of 70+

Code Hierarchy

└Z68Body mass index [BMI]└Z68.4Body mass index [BMI] 40 or greater, adult └Z68.45Body mass index [BMI] 70 or greater, adult

└Z68.45Body mass index [BMI] 70 or greater, adult