Anorexia nervosa, binge eating/purging type, extreme

This code signifies a severe form of anorexia nervosa characterized by recurrent episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, or enemas, or excessive exercise. Patients present with an extremely low body weight, defined as a BMI less than 15 kg/m² or less than the 5th percentile for age and sex in children/adolescents, along with an intense fear of gaining weight or becoming fat, and a distorted body image.

Apply this code when documentation clearly indicates a diagnosis of anorexia nervosa with a binge eating/purging subtype and the patient's current BMI falls into the extreme severity category. This typically requires a physician's diagnostic statement explicitly mentioning "anorexia nervosa, binge eating/purging type, extreme" or providing objective measures (e.g., BMI) that meet the extreme severity criteria.

• Ensure the documentation specifies both the binge eating/purging subtype and the "extreme" severity level based on BMI.
• Do not confuse this with other eating disorders like bulimia nervosa, which does not involve extreme low body weight.
• Always sequence this code as the primary diagnosis when it is the focus of the encounter.