All codes
V857
V857 – V857
OHIP Other Code · Schedule of Benefits
When to Use
- Use V857 to report a patient's Body Mass Index (BMI) of 40 or greater when it is a significant factor in the clinical management of a chronic condition.
- Apply this code as a secondary diagnostic code alongside an E-code or chronic disease management code to justify increased complexity in obesity-related treatment plans.
Common Pitfalls
- Do not bill V857 as a primary diagnosis code, as it is a supplementary classification code that requires an associated primary diagnosis to be valid for payment.
- Avoid using V857 for patients with a BMI under 40, as it specifically denotes morbid obesity and will be flagged during manual audits if the clinical record does not support the threshold.
Billing Tips
- Ensure the calculated BMI value is explicitly documented in the patient's chart to support the use of V857 if the claim is subject to a post-payment review.
Provider Fee$0.00
Specialist Fee$0.00
Effective: April 1, 2025
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