Obesity

There is no question that Obesity adds additional complexity to any surgical procedure. The Obesity epidemic has led to the development of the specialty of Bariatric Surgery, however most General Surgeons still perform the majority of surgical interventions for high BMI patients. If you struggle with a procedure on an obese patient, you can use modifier 22 – Increased Procedural Services but “documentation must support the substantial additional work and the reason for the additional work (i.e., increased intensity, time, technical difficulty of procedure, severity of patient's condition, or physical and mental effort required). Note that there also is a code for “Inconclusive diagnostic imaging due to excess body fat of patient” – R93.9 pointing to the recognition that taking care of obese patients is difficult.

 See the chart below on proper coding for the BMI.