E66.2 Morbid (severe) obesity with alveolar hypoventilation

ICD10CM code

#### Name of the Condition
- Morbid (severe) obesity with alveolar hypoventilation
- Also known as Obesity Hypoventilation Syndrome (OHS) or Pickwickian syndrome

#### Summary
Morbid obesity with alveolar hypoventilation is a condition where severe obesity affects breathing during sleep and while awake, leading to increased carbon dioxide levels in the blood (hypercapnia) and reduced oxygenation.

#### Causes
- Combination of excessive body weight and inadequate respiratory function.
- Central respiratory drive dysfunction.
- Upper airway obstruction during sleep.

#### Risk Factors
- Severe obesity (BMI over 40).
- Sedentary lifestyle.
- Poor eating habits.
- Genetic predisposition.
- Sleep apnea.

#### Symptoms
- Daytime sleepiness and fatigue.
- Loud snoring and disrupted sleep.
- Shortness of breath.
- Morning headaches.
- Difficulty concentrating.

#### Diagnosis
- Physical examination and medical history.
- Blood tests to measure blood gases.
- Pulmonary function tests.
- Polysomnography (sleep study).

#### Treatment Options
- Weight loss through dietary changes and exercise.
- Use of Continuous Positive Airway Pressure (CPAP) machines.
- Bariatric surgery for eligible patients.
- Medications to stimulate breathing.

#### Prognosis and Follow-Up
- Prognosis improves significantly with weight loss and effective management of symptoms.
- Regular follow-up is essential to monitor respiratory function and adjust treatments.

#### Complications
- Pulmonary hypertension.
- Right-sided heart failure.
- Severe hypoxemia.
- Reduced quality of life.

#### Lifestyle & Prevention
- Adopting a healthier diet and regular exercise regimen to manage weight.
- Avoiding alcohol and sedatives, which can exacerbate symptoms.
- Routine monitoring of sleep patterns.

#### When to Seek Professional Help
- Persistent symptoms of sleep apnea or difficulty breathing.
- Daytime fatigue that interferes with daily activities.
- Signs of cardiovascular strain or increased blood pressure.

#### Additional Resources
- American Academy of Sleep Medicine (AASM): [www.aasm.org](http://www.aasm.org)
- Obesity Action Coalition: [www.obesityaction.org](http://www.obesityaction.org)

#### Tips for Medical Coders
- Ensure the presence of both severe obesity and alveolar hypoventilation is documented before assigning ICD code E66.2.
- Be aware of overlapping conditions like obstructive sleep apnea and code separately if documented.
- Avoid assuming respiratory issues without proper documentation.

Medical Policies and Guidelines for Morbid (severe) obesity with alveolar hypoventilation

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