I recently had an MD comment about a query for morbid obesity. Their concern was, yes the patient may be morbidly obese, but we are not doing anything for it. We are not medically managing this diagnosis.
So, why do we query for morbid obesity? Morbid obesity is a secondary diagnosis that can be very clinically significant.Taking care of these patients can cause multiple issues for clinical staff. Morbidly obese patients often require specialty beds, equipment and require the use of increased nursing resources. Think of the patient that requires multiple staff members for simple care such as routine turns.
Other concerns include an increased danger of developing skin ulcers, changes in medication dosing and difficulty in getting clear views during radiological studies.
With these complications, a documented diagnosis of morbid obesity will increase the severity of illness for a patient.This results in higher Healthgrades scores for the MD who consistently documents morbid obesity in their patients.
So how do you diagnose morbid obesity?
Salem Health has a standard definition in Epic for obesity and morbid obesity, based on the patient’s BMI. A patient with a BMI of >/= to 30 is considered obese, and a patient with a BMI of >/= to 40 is morbidly obese. These diagnoses can only be coded if they are documented by an attending physician. The coder cannot simply code from the BMI in the chart.
Being aware of your patient’s BMI and documenting morbid obesity when appropriate will help you avoid a query.