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B.3.5.1. Cachexia: While reporting cachexia, it needs strong support to confirm the code (799.4). The following can constitute as a plan of care for cachexia - muscle and fat loss, GI related problems and a marked declined in patient function, B.3.5.2. BMI & Morbid obesity: High BMI (V85.41, V85.42, V85.43, V85.44, and V85.45) should be captured, in spite of them not being Part C HCC codes. Since BMI is an ‘additional Dx’ as categorized per ICD-9 guidelines, it should always be reported along with the primary Dx. Otherwise, the BMI code should be sent back to the provider to address the primary diagnosis in such cases. Morbid obesity can be confirmed on the basis of the following POC’s: Diet control, Exercise, Discussion of weight loss etc. You should ‘confirm’ the morbid obesity when the document states patient unable to ambulate due to weight, difficulty breathing, and pain and associated disease like fatty liver. Whenever the addressed BMI value in the progress note ≥37, and documentation should have morbid obesity. Then morbid obesity can be considered and confirmed based on plan of care. Reference: Client Call; Known From Sharon and Shantell ; Date: 07/17/2013. When an encounter (say 1/4/2013) documents Morbid Obesity with BMI of 39.45 with POC and another encounter (say 5/4/2013) documents Morbid Obesit with BMI of 40.35 without POC. Confirm 278.01 (Morbid Obesity) from 1/4/2013 and there is no need to pend V85.41 (BMI > 40) and ask for POC. B.3.5.3. Malnutrition: Malnutrition in the elderly is under-documented and under-treated. The coder/reviewer should be aware of this important potential diagnosis. Malnutrition commonly accompanies illnesses such as: cancer, pancreatitis, alcohol abuse/dependence, liver disease, chronic kidney disease, drug abuse/dependence, obesity, end-stage renal disease (ESRD), alcoholic hepatitis, cirrhosis, celiac disease, cystic fibrosis, and anemia