All codes
V854
V854 – V854
OHIP Other Code · Schedule of Benefits
When to Use
- Use V854 as a diagnostic code to identify a patient with a Body Mass Index (BMI) of 40.0 or greater when billing for obesity-related counseling or management.
- Include this code alongside E66.9 (Obesity, unspecified) to provide specific clinical context for the severity of the patient's condition during primary care encounters.
Common Pitfalls
- Do not use V854 as a standalone billing code, as it is a supplementary diagnostic code and does not carry a fee or represent a billable service on its own.
- Avoid using V854 for patients with a BMI below 40.0, as this constitutes inaccurate diagnostic coding and can trigger audit flags for inappropriate clinical documentation.
Billing Tips
- Always pair V854 with a valid service code (such as A007 or K030) to ensure the claim is processed correctly while documenting the patient's high-risk BMI status.
Provider Fee$0.00
Specialist Fee$0.00
Effective: April 1, 2025
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