ICD Code R63.4

ICD code R63.4 is used to identify and document cases of abnormal weight loss. This code is applied when a patient experiences a significant and unintended reduction in body weight, which may be indicative of underlying health issues or conditions that require further investigation and management by healthcare providers.

When considering the use of the ICD code for abnormal weight loss, healthcare providers should evaluate the following diagnostic criteria and symptoms:

1. Unintentional Weight Loss: The patient experiences a significant reduction in body weight without actively trying to lose weight through diet or exercise.

2. Weight Loss of More Than 5%: The patient has lost more than 5% of their body weight over a period of 6 to 12 months, which is considered clinically significant.

3. Persistent Weight Loss: The weight loss is ongoing and not explained by recent changes in diet, physical activity, or lifestyle.

4. Associated Symptoms: The patient may present with additional symptoms such as fatigue, weakness, or decreased appetite, which could indicate an underlying health issue.

5. Exclusion of Common Causes: The weight loss is not attributable to common causes such as increased physical activity, dietary changes, or known medical conditions like diabetes or hyperthyroidism.

6. Medical Evaluation: A thorough medical evaluation has been conducted to rule out other potential causes, including gastrointestinal disorders, malignancies, or chronic infections.

7. Impact on Health: The weight loss is having a noticeable impact on the patient's overall health, potentially leading to nutritional deficiencies or other health complications.

8. Documentation: The weight loss and associated symptoms are well-documented in the patient's medical records, providing a clear basis for the use of the ICD code.

By adhering to these criteria, healthcare providers can ensure accurate coding and effective management of patients experiencing abnormal weight loss.

For the ICD code R63.4 (Abnormal weight loss), the relevant CPT codes that may be applicable for treatment or evaluation include:

1. 99201-99205 - Office or other outpatient visit for the evaluation and management of a new patient.

2. 99211-99215 - Office or other outpatient visit for the evaluation and management of an established patient.

3. 99381-99397 - Preventive medicine services, which may include comprehensive evaluation and management.

4. 99401-99404 - Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual.

5. 97802-97804 - Medical nutrition therapy, which may be relevant for addressing nutritional aspects of weight loss.

6. 99441-99443 - Telephone evaluation and management service provided by a physician or other qualified healthcare professional.

7. G0447 - Face-to-face behavioral counseling for obesity, 15 minutes.

These CPT codes are examples of services that might be utilized in the evaluation, management, or treatment of a patient presenting with abnormal weight loss. The selection of specific codes would depend on the individual patient's clinical situation and the services provided.

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