P05 KE-P05 · 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-00005 · library_default_set@1.0 · library-engine 1.0 · replay 45d2d6965e14bb29… · 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-P05 · bmi
Title: Clarification request: body-mass index values
Encounter: KE-P05   Patient: P05   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-00005

Clinical indicators from the health record:
- Visit diagnosis list entry: "Obesity, unspecified" [visit diagnosis list LD-P05-1]
- Body-mass index 37.2 kg/m2 (2026-11-12 09:10) [measurement LM-P05-01]

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

Response options (select one or write your own):
( ) Obesity, class 1
( ) Obesity, class 2
( ) Obesity, class 3
( ) Overweight
( ) Not clinically significant for this encounter
( ) Other (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 (3)
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 Class 2 obesity: 35 to less than 40 bmi 37.2 kg/m2 2026-11-12 09:10 · LM-P05-01 Window: 365 days before the check. Another published definition (`who_adult_bmi@1.0`) gives: Obesity: BMI ≥30. 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))	Supported, but entered or stated less specifically than the record supports entered E66.9 (Obesity, unspecified) The code family 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. 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 Codes in this family for the category the record supports: `E66.812` Obesity, class 2. Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).
Diabetes mellitus measured	`ada2026_diabetes@1.0` Draft · pending review Not assessable: no measurement in the window hba1c 6.8 % 2026-11-12 08:00 · LM-P05-04 Window: 730 days before the check. Citation Diabetes diagnostic thresholds and the confirmation rule (ADA Standards of Care 2026) ada2026_diabetes@1.0 Table 2.1: A1C ≥6.5% (≥48 mmol/mol); FPG ≥126 mg/dL (≥7.0 mmol/L); 2-h PG ≥200 mg/dL (≥11.1 mmol/L) during OGTT; random plasma glucose ≥200 mg/dL (≥11.1 mmol/L) with classic symptoms of hyperglycemia or hyperglycemic crisis. In the absence of unequivocal hyperglycemia, diagnosis requires two abnormal results from different tests ... or the same test at two different time points. American Diabetes Association Professional Practice Committee, 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026 (2026) · Table 2.1 Criteria for the diagnosis of diabetes in nonpregnant individuals · source Not encoded: Type of diabetes (type 1, type 2, other) is not assessed. Conditions that make A1C unreliable (some haemoglobin variants, pregnancy, G6PD deficiency, HIV, anaemia, haemodialysis, erythropoietin; recommendation 2.4 and text) are not checked: A1C results are used as sent. No maximum interval between the two abnormal results is stated by the source and none is applied. Whether the test method is NGSP-certified and whether a fasting sample was truly fasting are asserted by the sender through the analyte name. When two different tests are discordant ADA advises repeating the abnormal test; this entry simply reports one abnormal result.	Not stated	None entered	Cannot be assessed single
Code-family reference: Diabetes mellitus Coders only reference for coders — the clinician's documented statement governs; the software does not assign codes `E11` Type 2 diabetes mellitus: distinguishes type 2 diabetes with or without complications by body system (kidney, eye, nerve, circulatory, skin, oral, hypoglycaemia, hyperglycaemia, ketoacidosis, hyperosmolarity), long-term drug use is separate (Z79) (87 codes in the category). 87 codes; see the official files `E10` Type 1 diabetes mellitus: distinguishes type 1 diabetes with the same complication axes as E11 (87 codes in the category). 87 codes; see the official files Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).
Prediabetes measured	`ada2026_prediabetes@1.0` Draft · pending review Criteria not met: A result is in the diabetes range — prediabetes not assigned; see ada2026_diabetes hba1c 6.8 % 2026-11-12 08:00 · LM-P05-04 Window: 365 days before the check. Citation Prediabetes ranges (ADA Standards of Care 2026) ada2026_prediabetes@1.0 A1C 5.7–6.4% (39–47 mmol/mol); FPG 100 mg/dL (5.6 mmol/L) to 125 mg/dL (6.9 mmol/L) (IFG); 2-h PG during 75-g OGTT 140 mg/dL (7.8 mmol/L) to 199 mg/dL (11.0 mmol/L) (IGT) American Diabetes Association Professional Practice Committee, 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026 (2026) · Table 2.2 Criteria defining prediabetes in nonpregnant individuals · source Contested: Other bodies (for example WHO) are understood to use a different impaired fasting glucose range and not to use an A1C prediabetes range; those texts were not opened, so no other thresholds are recorded. Review item. Not encoded: ADA does not require confirmation for prediabetes in Table 2.2; none is applied. A1C reliability conditions are not checked (see ada2026_diabetes). Only the most recent result of each test is used.	Not stated	None entered	Nothing to act on
Code-family reference: Prediabetes Coders only reference for coders — the clinician's documented statement governs; the software does not assign codes `R73` Elevated blood glucose level: distinguishes R73.01 impaired fasting glucose, R73.02 impaired glucose tolerance (oral), R73.03 prediabetes, R73.09 other abnormal glucose, R73.9 hyperglycaemia unspecified (5 codes in the category). `R73.01` Impaired fasting glucose `R73.02` Impaired glucose tolerance (oral) `R73.03` Prediabetes `R73.09` Other abnormal glucose `R73.9` Hyperglycemia, unspecified Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).