ICD-10 E66.813
Billable / Specific HCC v28: 22Obesity, class 3
About ICD-10-CM E66.813
ICD-10-CM code E66.813 represents Obesity, class 3. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E66). The 2026 edition of ICD-10-CM E66.813 became effective on October 1, 2025.
Coding Tips for E66.813
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
E66.813 is a CMS-HCC v28 risk-adjustment code (category 22). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for E66.813
Local Coverage Determinations (LCDs) from CMS MACs that list E66.813 as a covered diagnosis.
Showing top 10 of 143 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing E66.813.
5 Medicare
1 Aetna
CPT Codes Commonly Billed with E66.813
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 0003M CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis CMS LCD
- 0468U CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis CMS LCD
- 0166U CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis CMS LCD
- 81517 CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis CMS LCD
- 0344U CMS LCD: Billing and Coding: MolDX: Biomarker Testing for Risk Stratification in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis CMS LCD
Codes Adjacent To E66.813
Other codes in section E65-E68 (Overweight, obesity and other hyperalimentation).
ICD-10 E66.813, Billing FAQ
Is ICD-10 code E66.813 billable? +
Yes, E66.813 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does E66.813 affect Medicare Advantage HCC risk adjustment? +
Yes. E66.813 maps to CMS-HCC v28 category 22. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What CPT codes are commonly billed with E66.813? +
Procedures frequently paired with E66.813 include: 0003M, 0468U, 0166U, 81517, 0344U.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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