P02 KE-P02 · outpatient visit

One row per condition family: what the record supports under the published definition, what the note states, the visit's diagnosis entries, and an assessment. Codes are coded from the signed documentation; the software never assigns one.

Library check LRUN-00002 · library_default_set@1.0 · library-engine 1.0 · replay 823d08e0e0d974b0… · Data (JSON)

Draft query: Obesity / overweight / underweight (body-mass index)

Blocked by the query linter

A non-leading clarification request: clinical indicators with their sources, an open question, several options plus "other" and "unable to determine". No code and no payment word; the same indicators cannot be queried twice.

DOCUMENTATION QUERY (draft) for KE-P02 · bmi
Title: Clarification request: body-mass index values
Encounter: KE-P02   Patient: P02   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: cdc_adult_bmi@1.0, library_default_set@1.0   Check run: LRUN-00002

Clinical indicators from the health record:
- Visit diagnosis list entry: "Obesity, unspecified" [visit diagnosis list LD-P02-1]
- Body-mass index 24 kg/m2 (2026-11-12 11:05) [measurement LM-P02-01]

Question:
Based on your independent clinical judgement, can the documentation of this condition be clarified in light of the body-mass index values listed above?

Response options (select one or write your own):
( ) Obesity, unspecified: confirmed (please document the supporting clinical information)
( ) Obesity, unspecified: ruled out
( ) Other explanation of the clinical findings (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.

error · no_sender: A query needs a named human sender (sign in).

Condition families for this encounter (2)
Condition family	What the record supports	What the note states	Visit diagnosis entries	Assessment
Obesity / overweight / underweight (body-mass index) measured	`cdc_adult_bmi@1.0` Draft · pending review Criteria not met: Healthy weight: 18.5 to less than 25 bmi 24 kg/m2 2026-11-12 11:05 · LM-P02-01 Window: 365 days before the check. Another published definition (`who_adult_bmi@1.0`) gives: BMI below 25. Citation Adult BMI categories: underweight, healthy weight, overweight, obesity classes 1-3 (CDC) cdc_adult_bmi@1.0 Underweight: Less than 18.5; Healthy Weight: 18.5 to less than 25; Overweight: 25 to less than 30; Obesity: 30 or greater; Class 1 Obesity: 30 to less than 35; Class 2 Obesity: 35 to less than 40; Class 3 Obesity (Severe Obesity): 40 or greater Centers for Disease Control and Prevention, Adult BMI Categories (2024) · Adult BMI categories table · source Contested: BMI cut-offs are population-specific (WHO 2004 expert consultation proposed lower action points for Asian populations; not opened) and BMI does not measure adiposity directly; the CDC page applies the categories 'regardless of age, sex, or race' for adults. Not encoded: The CDC page states no exception for pregnancy, athletes or ethnicity; population-specific cut-offs (for example lower thresholds proposed for Asian populations) are not encoded. BMI is a screening measure (CDC); obesity as a disease (for example the 2025 Lancet Commission 'clinical obesity') needs other assessment. BMI is taken as recorded; it is not computed from weight and height.	Not stated	`E66.9` Obesity, unspecified (visit diagnosis list (synthetic))	Entered or stated without support in the record Draft a query
Code-family reference: Obesity / overweight / underweight (body-mass index) Coders only reference for coders — the clinician's documented statement governs; the software does not assign codes `E66` Overweight and obesity: distinguishes overweight (E66.3), obesity class 1/2/3 (E66.811-E66.813), morbid obesity due to excess calories or with alveolar hypoventilation, drug-induced, other, unspecified (10 codes in the category). `E66.01` Morbid (severe) obesity due to excess calories `E66.09` Other obesity due to excess calories `E66.1` Drug-induced obesity `E66.2` Morbid (severe) obesity with alveolar hypoventilation `E66.3` Overweight `E66.811` Obesity, class 1 `E66.812` Obesity, class 2 `E66.813` Obesity, class 3 `E66.89` Other obesity not elsewhere classified `E66.9` Obesity, unspecified `Z68` Body mass index [BMI]: distinguishes BMI value bands for adults (Z68.1-Z68.45) and percentile bands for paediatrics (Z68.5-) (33 codes in the category). `Z68.18` Body mass index [BMI] 18.4 or less, adult `Z68.19` Body mass index [BMI] 18.5-19.9, adult `Z68.20` Body mass index [BMI] 20.0-20.9, adult `Z68.21` Body mass index [BMI] 21.0-21.9, adult `Z68.22` Body mass index [BMI] 22.0-22.9, adult `Z68.23` Body mass index [BMI] 23.0-23.9, adult `Z68.24` Body mass index [BMI] 24.0-24.9, adult `Z68.25` Body mass index [BMI] 25.0-25.9, adult `Z68.26` Body mass index [BMI] 26.0-26.9, adult `Z68.27` Body mass index [BMI] 27.0-27.9, adult `Z68.28` Body mass index [BMI] 28.0-28.9, adult `Z68.29` Body mass index [BMI] 29.0-29.9, adult `Z68.30` Body mass index [BMI] 30.0-30.9, adult `Z68.31` Body mass index [BMI] 31.0-31.9, adult `Z68.32` Body mass index [BMI] 32.0-32.9, adult `Z68.33` Body mass index [BMI] 33.0-33.9, adult `Z68.34` Body mass index [BMI] 34.0-34.9, adult `Z68.35` Body mass index [BMI] 35.0-35.9, adult `Z68.36` Body mass index [BMI] 36.0-36.9, adult `Z68.37` Body mass index [BMI] 37.0-37.9, adult `Z68.38` Body mass index [BMI] 38.0-38.9, adult `Z68.39` Body mass index [BMI] 39.0-39.9, adult `Z68.41` Body mass index [BMI] 40.0-44.9, adult `Z68.42` Body mass index [BMI] 45.0-49.9, adult `Z68.43` Body mass index [BMI] 50.0-59.9, adult `Z68.44` Body mass index [BMI] 60.0-69.9, adult `Z68.45` Body mass index [BMI] 70 or greater, adult `Z68.51` Body mass index [BMI] pediatric, less than 5th percentile for age `Z68.52` Body mass index [BMI] pediatric, 5th percentile to less than 85th percentile for age `Z68.53` Body mass index [BMI] pediatric, 85th percentile to less than 95th percentile for age `Z68.54` Body mass index [BMI] pediatric, 95th percentile for age to less than 120% of the 95th percentile for age `Z68.55` Body mass index [BMI] pediatric, 120% of the 95th percentile for age to less than 140% of the 95th percentile for age `Z68.56` Body mass index [BMI] pediatric, greater than or equal to 140% of the 95th percentile for age `R63` Symptoms and signs concerning food and fluid intake: distinguishes R63.6 underweight (one code) (11 codes in the category). `R63.0` Anorexia `R63.1` Polydipsia `R63.2` Polyphagia `R63.30` Feeding difficulties, unspecified `R63.31` Pediatric feeding disorder, acute `R63.32` Pediatric feeding disorder, chronic `R63.39` Other feeding difficulties `R63.4` Abnormal weight loss `R63.5` Abnormal weight gain `R63.6` Underweight `R63.8` Other symptoms and signs concerning food and fluid intake Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).
Anaemia measured	`who2024_anaemia@1.0` Draft · pending review Not assessable: needed to choose the population-specific thresholds: context 'pregnant' not provided; needed to choose the population-specific thresholds: context 'trimester' not provided haemoglobin 128 g/L 2026-11-12 11:00 · LM-P02-04 Window: 30 days before the check. Citation Anaemia and its severity by haemoglobin (WHO 2024) who2024_anaemia@1.0 Table 3: Adults, 15–65 years, nonpregnant women: No anaemia ≥120; Mild 110–119; Moderate 80–109; Severe <80. Adults, 15–65, years men: ≥130; 110–129; 80–109; <80 (g/L) World Health Organization, Guideline on haemoglobin cutoffs to define anaemia in individuals and populations (2024) · Executive summary: Table 2 (PDF page 12), Table 3 (PDF page 13), Table 4 (PDF page 14), Table 5 (PDF page 15) · source Contested: Cut-offs are 5th percentiles of mostly higher-income populations (WHO's own remark); the men's 130 g/L cut-off and severity percentages were debated by the guideline group; CTCAE and laboratory reference ranges use other limits; older adults (>65) are not covered. Not encoded: The elevation formula (0.0056384 x elevation + 0.0000003 x elevation²) is not used; the 500 m table rows are. The remark that tailored adjustments may be warranted above 2500 m is not encoded. Adjustment for inflammation/infection (malaria) and for genetic ancestry: WHO recommends none (normative statements 2.b and 2.c); nothing is applied. Type and cause of anaemia (iron deficiency, blood loss, haemolysis) are not assessed. Persons older than 65 years and infants under 6 months: Table 2 gives no cut-off, so they are not assessable. Exactly 20 cigarettes per day: Table 5 lists '10–19' and '>20', so 20 per day is outside the table and not assessable (source gap).	Not stated	None entered	Cannot be assessed context
Code-family reference: Anaemia Coders only reference for coders — the clinician's documented statement governs; the software does not assign codes `D64` Other anemias: distinguishes type of anaemia (sideroblastic, congenital dyserythropoietic, due to antineoplastic chemotherapy, other specified, unspecified) (8 codes in the category). `D64.0` Hereditary sideroblastic anemia `D64.1` Secondary sideroblastic anemia due to disease `D64.2` Secondary sideroblastic anemia due to drugs and toxins `D64.3` Other sideroblastic anemias `D64.4` Congenital dyserythropoietic anemia `D64.81` Anemia due to antineoplastic chemotherapy `D64.89` Other specified anemias `D64.9` Anemia, unspecified `D50` Iron deficiency anemia: distinguishes iron deficiency anaemia: secondary to chronic blood loss, sideropenic dysphagia, other, unspecified (4 codes in the category). `D50.0` Iron deficiency anemia secondary to blood loss (chronic) `D50.1` Sideropenic dysphagia `D50.8` Other iron deficiency anemias `D50.9` Iron deficiency anemia, unspecified `D62` Acute posthemorrhagic anemia: distinguishes acute posthaemorrhagic anaemia (single code) (1 codes in the category). `D62` Acute posthemorrhagic anemia Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).