Coding Tip: Body Mass Index (BMI) Reporting in Pregnancy

After much confusion, we were finally given an answer regarding reporting of BMI in pregnancy back in 2019. The guideline states “do not assign BMI codes during pregnancy.” A female of normal weight at conception that gains the recommended 25 to 35 pounds during the pregnancy will have a BMI that measures in the overweight range at the time of delivery. This is not a true reflection of the patient being overweight or having too much body fat.

 

What is BMI in Adults?

This is the body mass (weight) divided by the body height and is expressed in units kg/m2. The BMI is used to determine the amount of tissue mass (muscle, fat and bone) in a person. This is then used to help determine if a person is underweight, normal weight, overweight, or obese. The BMI can be used to screen for body fat but is not diagnostic. These values are different depending on the population (such as the Asian population vs. European).

Common BMI Ranges:

  • Underweight is under 18.5 kg/m2
  • Normal weight is 18.5 to 25 kg/m2
  • Overweight is 25 to 30 kg/m2
  • Obese is over 30 kg/m2

Common Diseases Associated with High BMI (Overweight/Obese):

  • Hypertension
  • Type 2 diabetes mellitus
  • Coronary artery disease
  • Stroke
  • Sleep apnea
  • Hyperlipidemia
  • Osteoarthritis or general body pain
  • Depression
  • Low quality of life
  • Malignancy

References
wikipedia.org/wiki/Body_mass_index
cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-weight-gain/art-20044360
AHA Coding Clinic for ICD-10-CM/PCS, Fourth Quarter 2018 Page: 80

The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.

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