HCC Best Practice: Suspected Morbid Obesity

BPA Spotlight - Morbid Obesity Suspect BPA

To help providers identify patients with a potential Morbid Obesity (HCC 22) diagnosis, the Clinical Documentation Excellence (CDE) Team has created logic within the HCC Best Practice Advisory (BPA) based on the following criteria:

HCC 22 - Morbid Obesity  - (1 and 2)

• Patient is greater than or equal to 18  
• BMI is over 40  

Severe Obesity with Comorbidities  (1 and 2 and 3)

1. BMI less than 40  
2. BMI greater or equal to 35
3. Has comorbidity on problem list, encounter dx, or invoice dx  

• Hypertension
• Dyslipidemia  
• Cardiovascular Disease  
• Stroke Primary Diagnosis Cohort  
• Obstructive Sleep Apnea  
• Ischemic Heart Disease  
• Gallbladder Disease  

Identifying the suspect BPA

• Morbid Obesity Suspected BPAs will always have a header above the condition with the language “Probable Condition Based on Epic Documentation – Morbid Obesity” in a Grey Bar.
• Any Suspected Conditions will populate towards the top portion of the BPA tool.
• Similar to the standard Recapture Chronic Conditions in the BPA, the provider will always have the button selections of “Add Visit Diagnosis” to add the condition; “Do Not Add” to suppress the alert to the next appointment; or “N/A to Patient” to disagree and remove the condition from the tool.
• To refer to the logic outlined above, the provider can select the “link” hyperlink from the “For more information on Ochsner / Epic Probable Condition Logic click this link.