E66.813
E66.813: Obesity, class 3
Billable / specific codeICD-10-CM
E66.813 is a billable, specific ICD-10-CM code for obesity, class 3. It is valid for submission on a claim.
Check E66.813 with the rest of the claim: free scrubberOther codes that can never be billed with E66.813
Their own Excludes1 notes name this code, so the conflict is not listed above.
- R63.5Abnormal weight gain
Risk adjustment
E66.813 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 48 Morbid Obesity0.186 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
E66.813 is named in 15 Medicare coverage policies: 15 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A54923Billing and Coding: Bariatric Surgery for Treatment of Co-Morbidities Conditions Related to Morbid Obesity
- A56852Billing and Coding: Laparoscopic Sleeve Gastrectomy for Severe Obesity
- A57065Billing and Coding: Outpatient Psychiatry and Psychology Services
- A57145Billing and Coding: Surgical Management of Morbid Obesity
Alphabetic index entries that lead here
- Obesity›class›3
The condition this code belongs to
Code history
- addedFY2024-FY2027
Obesity, class 3