2027 ICD-10-CM Diagnosis Code E66.2Morbid (severe) obesity with alveolar hypoventilation

ICD-10-CM Codes›E00–E89›E65-E68›E66

ICD-10-CM E66.2
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

E66.2 is a billable ICD-10-CM diagnosis code for morbid (severe) obesity with alveolar hypoventilation. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 205 through 206. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 13 closely related codes. Coders also document this condition as alveolar hypoventilation. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Obesity.

For Medicare Advantage risk adjustment, E66.2 maps to CMS-HCC Category 48 (Morbid Obesity) under the V28 model, adding a risk factor of about 0.186 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
E66.2
Billable Status
Yes — Valid for Submission
Code Describes
Morbid (severe) obesity with alveolar hypoventilation
Short Description
Morbid (severe) obesity with alveolar hypoventilation
Same as the full description in the CMS dataset.
Parent Code
Overweight and obesity

Code Classification

ChapterE00–E89Endocrine, nutritional and metabolic diseases
SectionE65-E68Overweight, obesity and other hyperalimentation
CategoryE66Overweight and obesity
This CodeE66.2Morbid (severe) obesity with alveolar hypoventilation

Medicare Risk Adjustment (HCC)Billing

E66.2 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 48— Morbid Obesity
Payment HCC · PY 2027 one of 9 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.186
community, non-dual, aged · ranges 0.118–0.442 across segments
Hierarchy
Top of its hierarchy
HCC 48 is not superseded by any other condition category
Prior Model (CMS-HCC V24)
HCC 22
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 22 · ESRD (V21): HCC 22 · ESRD (V24): HCC 22
ESRD V21 weights: 0.073 dialysis, 0.278–0.429 functioning graft · ESRD V24 weights: 0.081 dialysis, 0.141–0.435 functioning graft
Part D (RxHCC)
Not mapped
E66.2 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Alveolar hypoventilation
  • Extreme obesity with alveolar hypoventilation
  • Morbid obesity

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to E66.2: its own notes plus those printed at E66 and Chapter 4. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Obesity hypoventilation syndrome (OHS)
  • Pickwickian syndrome

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From Chapter 4 (E00-E89) Endocrine, nutritional and metabolic diseases applies to 973 codes
  • transitory endocrine and metabolic disorders specific to newborn (P70-P74)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From E66 Overweight and obesity applies to 10 codes
  • adiposogenital dystrophy (E23.6)
  • lipomatosis dolorosa [Dercum] (E88.2)
  • lipomatosis NOS (E88.2)
  • Prader-Willi syndrome (Q87.11)

Code First

The underlying condition named in the note is sequenced before this code.

From E66 Overweight and obesity applies to 10 codes
  • obesity complicating pregnancy, childbirth and the puerperium, if applicable (O99.21-)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From E66 Overweight and obesity applies to 10 codes
  • code to identify body mass index (BMI), if known, for adults (Z68.1-Z68.45) or pediatrics (Z68.5-)

Notes

General instructions on how these codes are used.

From Chapter 4 (E00-E89) Endocrine, nutritional and metabolic diseases applies to 973 codes
  • All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name E66.2, its category, or a range that includes it.

Excludes1 3

These codes carry an Excludes1 note naming E66.2: they are not reported together with it, unless the two conditions are unrelated.

  • E66.01 Morbid (severe) obesity due to excess calories
    morbid (severe) obesity with alveolar hypoventilation (E66.2)
  • G47.3 Sleep apnea
    pickwickian syndrome (E66.2)
  • R63.5 Abnormal weight gain
    obesity (E66.-) names E66.-, which includes this code

Code First 1

These codes say to code first a condition named in the note, and E66.2 is one of the conditions named.

  • Z99.3 Dependence on wheelchair
    obesity (E66.-) names E66.-, which includes this code

Use Additional Code 2

These codes say to use an additional code from the note, and E66.2 is one of the codes named.

  • E88.81 Metabolic syndrome and other insulin resistance
    obesity (E66.-) names E66.-, which includes this code
  • O99.21 Obesity complicating pregnancy, childbirth, and the puerperium
    code to identify the type of obesity (E66.-) names E66.-, which includes this code

Index to Diseases and InjuriesGuidance

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR END009
Obesity
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Obesity Hypoventilation Syndrome

    hypoventilation syndrome in very obese persons with excessive adipose tissue around the abdomen and diaphragm. it is characterized by diminished to absent ventilatory chemoresponsiveness; chronic hypoxia; hypercapnia; polycythemia; and long periods of sleep during day and night (hypersomnolence). it is a condition often related to obstructive sleep apnea but can occur separately.

Patient EducationClinical

Obesity

Obesity is a disease that means having too much body fat. It is different from being overweight, which means weighing too much. Both terms mean that your weight is greater than what's considered healthy for your height.

The full article covers:

  • What is obesity?
  • What raises your risk of obesity?
  • How is obesity diagnosed?
  • What health problems can obesity cause?
  • What are the treatments for obesity?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert E66.2 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
278.03 Obesity hypovent synd
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About E66.2Overview

What is the ICD-10 code for morbid (severe) obesity with alveolar hypoventilation?

The ICD-10-CM code for morbid (severe) obesity with alveolar hypoventilation is E66.2 (sometimes written as E662). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is E66.2 (Overweight and obesity) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report morbid (severe) obesity with alveolar hypoventilation on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does E66.2 group to?

When morbid (severe) obesity with alveolar hypoventilation is the principal diagnosis on an inpatient stay, it groups to MS-DRG 206, 205, with relative weights from 0.9255 to 1.8244 depending on complications. Higher weights mean higher Medicare reimbursement.

Is E66.2 a CC or MCC?

CMS lists E66.2 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 13 closely related codes in its exclusion list.

Does E66.2 need an additional code?

When the condition applies, yes. The Use Additional Code note at E66, which applies to E66.2, reads: code to identify body mass index (BMI), if known, for adults (Z68.1-Z68.45) or pediatrics (Z68.5-). The additional code is reported after E66.2.

What HCC is E66.2?

E66.2 (morbid (severe) obesity with alveolar hypoventilation) maps to CMS-HCC Category 48 (Morbid Obesity), commonly written as HCC 48, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 22 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does E66.2 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, E66.2 adds a risk adjustment factor of about 0.186 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.118 to 0.442 depending on the payment segment). HCC 48 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 48 category page.